Sleep to Wake

By Kate Haas

I’m stopped at a busy intersection when it happens: My eyes close, then open, and for a few long, blank seconds, I can’t fathom how I got here. I can see the red traffic light swaying above me, the plastic flags fluttering brightly over the used car lot. But everything feels remote. I could close my eyes again, I think, and the world might disappear. I’m tempted to let it.

Fatigue presses on me like a weighted blanket. From beneath it, a thought emerges: No. I am on a four-lane street, at the wheel of a one-and-a-half ton vehicle. Soon the light will change. I need to wake up.

“Stop,” I say aloud, suddenly afraid. “Just stop this.” I don’t know who I’m talking to. But at the sound of my voice, the unreality recedes infinitesimally.

I switch off the radio, stilling the soothing saxophone music. The light changes. “Turn right,” I instruct myself, clutching the wheel like a terrified old lady. “There’s the Safeway, keep driving.” I narrate myself home like this, the sound of my voice tethering me to the car, the road, the world. When I get inside, I climb into my son’s bunk bed and close his blackout curtains, but I don’t sleep. I can’t sleep. That’s the problem.

•••

“Are you anxious about anything?” asks my doctor, not for the first time. She’s a bit younger than me, a mother; I like her. What I don’t like is this focus on my anxiety. I am untroubled by anything except my inability to sleep. Admittedly, it’s making me crazy.

“Nothing going on at home?” she presses.

My beloved grandmother died. I endured my parents’ bitter, protracted divorce. My Peace Corps journal was stolen, along with my backpack, en route from Casablanca to Dakar. A man I loved didn’t love me back. I had a terrible time breastfeeding. That’s it. Those are the worst things that have happened to me. My litany of woe is minor. My life, relatively speaking, has been a cakewalk.

“Nothing,” I tell her. “I’m a very lucky woman.”

But ten days ago, three hours after I went to sleep, I felt myself swimming unexpectedly up to consciousness. Beside me, my husband slept on. Out in the backyard, the wind stirred the heavy dark branches of the fir tree. Any moment now, I thought, I would dive down, back into sleep. Instead, I lay stranded on the surface.

We all have our strategies for this. Mine is reciting “Kubla Khan” in my head. Invariably, I’m asleep long before I get to the damsel with the dulcimer. This time, depressingly, I made it all the way to the end. There was Coleridge, ecstatically drinking the milk of paradise, while I watched the red numerals of the digital clock progress inexorably from two to three to four to five. Wakefulness felt like a door jammed open, and I couldn’t shut it.

It happened again the next night, and the next, and the next.

For years now, whenever my friends and I kvetch about our kids, someone always puts things in perspective: “Yeah, but at least they sleep through the night.” There’s a collective shudder. Like our memories of labor, the subsequent sleep deprivation is still disturbingly vivid. But that was a decade and a half ago. I was too old for this. By the fourth morning, I was queasy, snappish, fumbling for familiar words like a stroke victim. After ten days, during which I averaged three hours of sleep a night, I went to the doctor.

And really, I assure her now, nothing is troubling me. I explain about my loving husband, my healthy children, the work I enjoy, our generous health benefits. Even in my present affliction, I am fortunate: I work from home, so neither my freelance clients nor my bosses at the literary magazine can see me, haggard in my pajamas every afternoon, laboriously improving sentence flow.

My doctor prescribes a sedative and tells me to take it for a week, in the hope that this will re-set my system. At home, I shake one of the tiny white pills into my palm. It looks harmless, but I regard it with trepidation. I enjoy a glass of wine, but except for that one time with the marijuana cookies—all right, and that other time with the mushrooms—I have avoided mind-altering substances my entire life. Not out of moral qualms, but because they make me uneasy. This little pill is going to do something to my brain, something I can’t predict, and that scares me almost as much as the prospect of not sleeping. But I’m desperate. That night, I take the pill and go to bed. As always, my husband falls asleep in three minutes. I wait in the dark, listening to him breathe. Fifteen minutes later, I feel an unclenching in my body. A heaviness steals into my mind. Then it’s morning.

A week later, well-rested, I go to bed without taking the little pill. “You’ll be fine,” says my husband. Three minutes later, he is asleep. Three hours later, I am not. I try again the next night. But nothing has been re-set. Like a record with a skip, my brain wakes up at one a.m. each night, and nothing I try moves the needle back into the groove.

•••

“This medication can be addictive,” my doctor emails, when I report back to her. She tells me I can take up to three doses per week, and we arrange a follow-up two weeks from now.

“So that’s it. I’ll only sleep three nights out of seven,” I tell my husband.

“You don’t know that for sure,” he says.

I am too disheartened to believe him. But I pull myself together and try to think strategically. Which nights to take the medication? Sunday, for sure, so I can drive my son to cello on Mondays without killing anyone. Friday and Saturday, for a good weekend with my family? Or midweek, so I can work a few days with a clear head?

“It’s the Sophie’s Choice of insomnia,” I wail.

Immediately I feel guilty. Somewhere in Syria, a woman like me lies sleepless, wondering if the bombs will fall on her house tomorrow. I should think about her. But the insomnia has demoralized me with unnerving swiftness, shrinking my focus to my own exhaustion, and little else. If the universe is testing me, I am failing.

•••

A few days later, driving home from the grocery, I nearly hit a biker in an intersection. Appalled, I register his shocked face through the windshield. After that, I stop driving. My husband drives me to book group and picks me up. He arranges to take a morning off work for my next doctor’s appointment. One evening, I overhear him telling the kids to be extra patient and not argue so much, Mama’s having a hard time. I should be grateful. I am grateful. But I’m sick of feeling so damn pathetic.

I dread going to bed now, knowing that three hours is all my brain will allow me to rest. The moment of waking is the worst, the defeated awareness that it’s happened again; and then the despair as the dark hours pass, and the sky lightens, and the birds start up. If I could just make it to two a.m., I think, instead of one. But I never do.

I get used to moving sluggishly through the days, dazed and bewildered most of the time, yet performing basic functions all the same. I make school lunches, cook dinner. I don’t feel hungry myself, though. On a hunch, I try on a dress that’s been too snug for a while, and it zips up effortlessly. I stare at myself in the mirror, at my hips and breasts, outlined by the thin green fabric. Despite my pallor and unwashed hair, and the thick, smeary glass through which my brain seems to perceive everything these days, I look hot. I’m too tired to decide whether this is hopeful or disturbing.

•••

One night, after lying sleepless for three hours, I sit up and begin to cry with exhaustion. My husband wakes up and puts his arms around me. “Fucking Dick Cheney,” I sob. “He’s sleeping through the night. Why can’t I?”

At our house, when anyone is stricken by mysterious, troubling ailments, it is the custom to bitterly invoke the architects of America’s middle eastern wars. It began years ago, when my husband threw out his back while reaching innocently for a sock under the bed. “George Bush is killing thousands of Iraqis every day,” he railed then. “Why isn’t he immobilized on the floor with an ice pack?”

I nodded in commiseration. W. was undoubtedly enjoying robust health, the bastard.

Now, my husband reaches over and turns on the light. “Let me make you some warm milk,” he says.

“I tried that last week. It won’t do anything. Just go back to sleep, one of us has to feel normal around here.”

“Nope,” he says, undeterred by my grumpiness. “You’re my partner. If you’re awake, I’m awake. I’m going downstairs, and you can’t stop me.”

Five minutes later, he returns with a mug of milk. It is sweet with honey, and I tear up again, grateful to be married to such a mensch. Then I lie awake the rest of the night.

•••

Who pays thirteen dollars at the hippie mart for a tiny bottle of organic passionflower extract? People like me, that’s who, desperate people who’ve heard that this elixir will make them sleep. Dutifully, I dispense forty drops of the amber liquid into two ounces of water and down the mixture at bedtime. It tastes grassy and unpleasant, but that, I tell myself, is a small price to pay if it works. It does not work. Neither do calcium and magnesium, melatonin, multivitamins, sleeping in a different room, napping during the day, hot baths, or staying off the computer before bedtime.

“Maybe you need to relax,” says my husband. “Come on, let me just…”

That doesn’t work, either.

•••

One morning, after my usual three hours of shut-eye, I pause in the doorway of my twelve-year-old’s room. He’s reclining on his beanbag chair reading Origami Yoda, his floor littered with dirty socks, old Spanish worksheets, a couple of remote controls, a hot glue gun, and innumerable bits of other detritus. A surge of annoyance slices through my fatigue. “For the love of God, clean up this damn mess,” I snap.

The insomnia has produced two regrettable side effects: Everything irritates me, my children most of all. And while those children have long been forbidden to utter even the words “crap” and “suck,” in my presence, much less their saltier four-letter brethren, I myself now curse like a motherfucker. At first, the boys are impressed by the impact of sleeplessness on my formerly prim vocabulary. But soon enough they become amused, and then—to my aggravation—patronizing.

Now, my son looks up at me pityingly. “Did you forget to take your pill last night? Jeez, you need to chillax.”

If anything is more infuriating than intractable insomnia, it’s being told to chillax by a sixth grader.

“Don’t you say that to me!” It’s the wrong battle to pick, but I can’t stop myself. “Chillax? That’s not even a real word. Goddammit, I’m an English major! We have standards around here.” (I actually say these words.)

My son waggles a reproving finger at me. “Don’t be a swear bear,” he says sweetly.

A what kind of fucking bear? I am way too tired for this, but getting mad at him makes me feel less catatonic. “Clean up your room,” I shriek. “Now!”

He regards me solemnly. “Anger and hatred to the dark side only lead.”

•••

Because I know exactly how suggestible I am, I do not seek advice from the Internet about my insomnia. Until the day, a couple of months into it, when I do. And there, buried deep on the fourth or fifth page of results, I find it: proof that this was indeed a terrible idea. It’s a reference to a New Yorker article I read fourteen years ago but have forgotten until this moment, the story of an old Italian family, some of whose members lose the ability to sleep in middle age. For generations, no one has been able to predict who will be stricken by the rare condition, and there is no cure. After several excruciating years of sleeplessness, each victim dies.

I try hard not to dwell on this horrible story. It’s a very unusual condition, I remind myself. Also, I am not Italian. Although I am middle aged. And sleepless. When I tell my husband about the Italians, a look of mingled alarm and unease appears on his face, an expression whose specificity, after eighteen years of marriage, I have no trouble interpreting: He thinks I am losing it. I need to get a grip.

•••

I tell my doctor that I’m depressed. She perks up. “Oh? And was this a problem before the insomnia?”

Patiently, I explain that I am depressed because I can’t sleep.

“We could think about an anti-depressant. Sometimes it’s hard to pinpoint whether insomnia is a symptom, or the main issue.”

Do I really have to explain my perfect life? Again? I take a breath. She’s trying to help, she wants a fix for me, and I want one, too. But depression didn’t make me stop sleeping.

Maybe I’m cursed.

•••

My doctor refers me to a psychiatrist specializing in sleep disorders.

“That’s great,” says my husband, when I tell him about the psychiatrist. “You’re in the big leagues, now!”

“How can you be so damn cheerful all the time?”

“I’m sorry, did you want gloomy? Let me try again: A psychiatrist. Whoa. There is definitely something wrong with your brain.”

“Oh, shut up.”

“I see that smile.”

•••

At four in the morning, three weeks before my appointment, it occurs to me that this hopeless, unrelenting misery is what people contemplating suicide must experience. Suddenly, I cannot bear lying awake in the dark any longer. I get out of bed and email my doctor: “Three nights of sleep a week is unendurable. When I don’t take the pill, I lie awake all night in despair. I can’t work. I can’t write. I nearly hit a biker with my car.” (The biker was weeks ago, but what the hell.) “I cannot go on like this.”

My email must have struck the correct note of desperation. Four hours later my doctor writes back, instructing me to just take the pill every night until I check in with the psychiatrist.

•••

At my HMO, doctors work out of small gray rooms with florescent lighting, the only décor a queasily pinkish illustrated chart of the human body. Despite this, I cannot help picturing Dr. Sleep—as he is quickly dubbed in our house—behind an imposing mahogany desk. I’ve never even been to therapy, let alone a psychiatrist. If the pop culture of my formative years is to be believed, Dr. Sleep (aka Judd Hirsch in Ordinary People) will want to unearth some long-buried trauma that wakes me at one a.m. every night. Or he’ll want to put me on drugs. Neither prospect is appealing.

As it turns out, Dr. Sleep operates out of a windowless gray room, just like everyone else at Kaiser. He has sandy hair and an air of mild-mannered bemusement, reminding me forcibly of the hapless Arthur Dent in The Hitchhiker’s Guide to the Galaxy.

Dr. Sleep evinces little surprise as he takes my history. “And tell me about your mental state when you go to bed,” he says, tapping at his keyboard.

It’s been over three months since I have slept soundly without pharmaceutical assistance. Surely a bit of drama is permissible. “I feel like the Titanic heading into that final night,” I tell him. “Doomed.”

Dr. Sleep looks up from his keyboard, taken aback. “Oh, dear. That’s not good.”

I wonder what he expected me to say. His other patients must desperate, too. Or am I an extreme outlier? I renew my resolve not to mention the Italians.

Dr. Sleep scoots his rolling stool over to face me. I prepare for an inquiry into my murky past, or perhaps an evaluation of drug options. Dr. Sleep pursues neither of these avenues. “Do you bake bread?” he asks benignly.

I stare at him. As a matter of fact, I bake bread every Friday. But what can that have to do with anything?

“Think of your sleep as a ball of dough,” Dr. Sleep says, cupping his hands as if he’s holding one himself.

“Okay,” I say hesitantly. I imagine my challah dough: warm, heavy, eggy. Is this some visualization mind trick?

“You want your sleep to be compact, like a ball of dough,” says Dr. Sleep. “You want it to be compressed into just eight hours.” He moves his hands, as if firmly shaping the dough into an eight-hour ball. “When you stretch it out”—he moves his hands apart—”going to bed early, sleeping late, it’s like stretching the dough too far. It gets thin, full of holes, loses its integrity. That’s what you’ve been doing.”

Dr. Sleep is going to put me on a behavioral plan to compress my sleep, he tells me. That will fix everything.

“But I barely have any sleep to compress,” I protest.

He waves this away and explains the plan. Its main point involves breaking my mental association between wakefulness and being in bed. I am to stay away from my bedroom, except between the hours of eleven p.m. and six-forty-five a.m. At night, I am not to lie awake longer than twenty minutes at a time. After that, I must get up, go to another room, and engage in a “non-stimulating activity” until I feel sleepy. Then I can return to bed again. I am to repeat this as many times during the night as necessary. Also, I will cut my medication dose in half. The plan sounds implausible and exhausting, but I nod as if Dr. Sleep is handing me into a life raft, because maybe he is.

“You can read during your waking periods,” he tells me. “But nothing engaging. Do you have any boring books?”

I picture my biologist husband’s shelf of science texts. Yes, I tell Dr. Sleep, I certainly do.

That is how I find myself in my office at one-twenty a.m., headlamp shining on Mammals of the Pacific States by Lloyd G. Ingles. The first section of this heavy tome is devoted to teeth. I read about the tribophenic theory, which posits that our ancestral reptiles had molar cusps that migrated somewhere else in the jaw. I wait to feel sleepy, but even though this is possibly the most boring material I have ever read, I am wide awake. Eventually I yawn and go back to bed. I lie awake for another twenty minutes, then return to the office, and Ingles, and his damn teeth. This goes on for the rest of the night. By dawn I have gotten up and down a total of six times and advanced to the marsupials.

That morning, I fill in the chart Dr. Sleep gave me to track my progress: time in bed, number of times awake at night, final morning wake time, and so on. “This is the one you want to watch,” he told me, pointing to the space on the chart marked: TOTAL minutes/hours awake during the night. I pencil in four hours, forty-five minutes. In the box for notes, I scrawl: depressing and pointless.

But what else do I have? Half the medication is not enough to knock me out, so every night I follow Dr. Sleep’s plan, waking at 1, reading about mammals (Pacific shrew, vagrant shrew, dusky shrew, water shrew, marsh shrew, Inyo shrew, masked shrew, ornate shrew, pigmy shrew, gray shrew), not allowing myself to lie awake more than twenty minutes, scribbling my notes in the morning.

That first week, I run into an acquaintance in the park. We don’t know each other well, but I find myself telling her about the sleep plan. “More like the Guantanamo plan,” I grouse, demonstrating yet again the effect of sleep deprivation on my sense of perspective.

To my surprise, she confides that she, too, was prescribed this technique for insomnia. “It took a while, but it absolutely worked,” she says. “You have to hang in there.”

For the first time, it occurs to me that the plan is not some quixotic regime cooked up by Dr. Sleep, but an actual thing. A thing that might work.

On the sixth morning, I record something startling: although I got up to read four times, my total time awake was only two and a half hours. Even with half the medication, I got an astonishing five hours of sleep. By the end of the second week, my time awake has shrunk to one and a half hours.

My acquaintance was right. Dr. Sleep was right. Over the next month and a half, my sleep steadily improves. I go down to a quarter of a pill, then to no medication at all. By the end of June, nearly six months after the insomnia struck, it has vanished. The sleep plan was a life raft, after all, and now, incredibly, I am back on the mainland, with its rested, cheerful inhabitants, the weight of exhaustion lifted at last. This outcome is the result of science, I realize, in the form of a proven behavioral therapy. But it feels like something else.

It feels like luck: as random and inexplicable as the sleeplessness was.

•••

I will never know why I suddenly stopped sleeping, just like I’ll never know why cancer struck my grandmother, or my parents’ marriage ended the way it did, or why my first baby wouldn’t gain weight, no matter how much I nursed him. Possessions are lost, and love is sometimes unrequited, and we don’t always get to know why. I don’t believe that everything happens for a reason, not in the cosmic sense, anyway. If I did, I might conclude that insomnia was supposed to teach me something. Or maybe I would be less troubled by my knowledge that the Syrian woman is still lying awake.

I think about her now. I think about her every day. I think, too, about all the people who manage to meet hardship with dignity and grace and courage. Maybe the Syrian woman is one of them. Or maybe she isn’t. Maybe she’s more like me. Because when it came right down to it, I wasn’t one of those people. Confronted with adversity, I was irritable, profane, despairing, and self-absorbed. In a real Guantanamo scenario, I would never be the gutsy captive, steadfastly refusing to betray her comrades. Deprive me of sleep, and you can have the plans to the Death Star.

But then, no one expected me to be a hero, least of all myself. I’ve stood on the other side of that line. I’ve been the one to hold it together, to carry more than my share of the weight. This time, someone did those things for me. Wherever she is, and whatever she’s facing, awake or asleep, I’m wishing the Syrian woman the same luck.

•••

KATE HAAS is a senior editor at Literary Mama. Her essays have most recently appeared in the New York Times, the Boston Globe Magazine, OZY, and the Washington Post. She’s a regular contributor to Full Grown People and lives in Portland, Oregon with her family. Read more of her writing at www.katehaas.com.

Read more FGP essays by Kate Haas.

Sepia

flower — By Gina Easley www.GinaEasley.com

By Cora Schenberg

August 8, 2012. When I get scared, I lose my senses. I know that the walls of the clinic are acid green, but my eyes take in sepia.

“I’m glad you came in,” the doctor says. “Post-menopausal bleeding is never normal.”

Two weeks ago, my husband, son, and I were at the beach. I went into the bathroom to put on my bathing suit and found a spot of blood. I tried to ignore it. I figured the bleeding would stop by itself. When we got home and it hadn’t stopped, I called the clinic. The receptionist said my doctor was on vacation. Would I see Dr. A instead?

So here I am, bare-bottomed on crinkly paper.

“What do you think is wrong?” I ask the doctor.

“Unfortunately, I can’t tell anything from your exam. You’ll need to see a gynecologist. But I wouldn’t worry. It’s usually polyps or fibroids, which are benign.”

I had fibroids twenty years ago. Getting rid of them took major surgery and a six-week recovery. I don’t have time for this. I teach in the German Department at University of Virginia, and the semester starts in a few weeks.

Driving home from the clinic, I fall into a fantasy, where instead of undergoing a messy medical procedure, I can make time unspool, so the bleeding simply un-happens. I wouldn’t mind going back to April of this year, when our youngest nephew became bar mitzvah. The whole family was present and well. My husband Wade and I led the congregation in a favorite hymn. In a picture Wade’s sister sent, Wade, our son Gabriel, and I stand grouped around the bar mitzvah boy. Why can’t we step back into that picture?

But is that picture really where I want to end up? Gabriel, at seventeen, looks great, dwarfing all of us by at least a head and a half, his thick brown hair tousled, grin full of snark and confidence. But what about Gabriel’s parents? Mom’s got crow’s feet. Dad’s soft blue eyes show exhaustion; his once ginger hair has gone brown-grey. If we’re travelling in time, why not go back to when Wade and I met, in 1979? Or would it be better to return to October 16, 1983, when we said our vows before a rabbi? I remember how my hand turned radiant after Wade placed the ring on it. But then we didn’t have Gabriel. I wouldn’t want to live without him.

During my musing, I’ve been driving, and have now arrived at our house. I’m telling myself fantasizing won’t solve anything—besides, un-happen isn’t a word—when my teenager runs out, barefoot, to say that our friends the Smiths just called. “They’re coming for Shabbat dinner. Can you make lemon-ginger chicken?”

•••

Following Dr. A’s recommendation, I set up an appointment with my gynecologist. After examining me, Dr. B says, “I didn’t see any red flags in the exam, but let’s get you an ultrasound, to make sure you’re okay.”

A week later, she calls to say that the ultrasound tech “didn’t do a very good job,” so the picture is fuzzy. “However, it did show some fluid in the cul-de-sac between your uterus and rectum.”

“I’ve got a cul-de-sac? Like a dead-end street?”

The doctor laughs with me. But when I ask what caused the fluid, I hit a true dead end.

“I don’t know. But I’ve made you an appointment with a specialist, Dr. C. He’ll do the ultrasound himself, so there won’t be any problems.”

She gives me the date for Dr. C’s ultrasound: A month from now.

•••

The semester starts in a week. I feel exhausted all the time, and the bleeding is getting worse. I call Dr. D, my family doctor, to see if I’m anemic.

“Oh, I doubt dribbling for a month would make you lose much blood,” Dr. D says. “But sure, I’ll test your hemoglobin.” And a few minutes later, she reports, “Just as I thought—everything’s fine. And I see you’ve got an appointment with Dr. C. He’s the best.”

“But I have to wait another three weeks to see him.”

She smiles. “If he’s making you wait, it’s because he thinks your problem’s not serious.”

I’m fifty-five years old, but at this moment, I might as well be three. At the thought of contradicting the doctor, I picture myself as a pathetic, whining kid: but it hurts!

•••

The specialist, Dr. C, tells me I’m fine. “You’ve got a few fibroids, maybe a slight hormonal imbalance. But that’s not what’s making you bleed.”

“What is making me bleed, then?”

“We have to find out. I’m sure it’s nothing serious.”

Those words again. The doctor recommends a dilation and curettage, or D&C. “Very simple, a routine procedure.”

What planet have I landed on, where it’s “simple and routine” to be placed under total anesthesia while a doctor opens up and scrapes my uterus?

“My colleague, Dr. E, can do it,” Dr. C says.

•••

Sept. 16, 2012, a.k.a. Rosh Hashana, beginning of Jewish New Year 5773. At services, I stand between Wade and Gabriel. “Avinu Malkhenu, shema kolenu,” we chant. Our Father, our King, hear our prayer. A Hasidic legend tells us that on this day, the earth rises to the level of heaven. I imagine standing on tiptoes, whispering in God’s ear: “My doctors say I’m fine, but I don’t feel fine.” My belly aches and pulses. The holiday forces me to remember there’s no playing with time. We all petition God to inscribe us in the Book of Life for the coming year. But looking around, I see empty places where friends once sat. I wrap my prayer shawl around my shoulders and sink into the baritone voices of my husband and son.

•••

Dr. E’s office calls to say they’ve scheduled my dilation and curettage for September 26. I look at the calendar, see that day is Yom Kippur, and start to ask for a different date. But then I realize that since the surgery’s not until afternoon, I can attend most of the morning’s services. I write to the rabbi, explaining my situation. He writes back, promising prayers. And the Ritual Committee offers me an Aliyah—the chance to bless the Torah before the cantor reads from the scroll.

On Yom Kippur, I wake refreshed and energized, ready to pray the old melodies with lightness and joy that I’ve not felt in a long time. After the Torah reading, my family and I wave good-bye to the rabbi as we leave the sanctuary.

•••

Dr. E reports that my dilation and curettage was unusually difficult: “Your cervix was so tight, I hardly got any tissue at all. The good news is I’m pretty sure you don’t have cancer. But I’d like to do an endometrial biopsy to be certain.”

I agree to the biopsy; Dr. E. calls a week later.

“The tissue I got looks fine. You don’t have cancer.”

“You’re sure?”

“Positive. Malignant cells are very prominent. When I biopsy someone with cancer, all this brown stuff comes tumbling out.”

I shudder at the complacency with which she paints this horrid picture.

“What about the bleeding?” I ask.

“That’s a mystery. Honestly, Cora, we might never find out why you’re bleeding. Let me think about your case and get back to you.”

•••

As much as I like to play with time, I make an effort not to wish my life away. In college, we tended to live from one break to the next. We’d just gotten back from winter vacation when my freshman roommate Diana said, “It’s only two months till spring break!”

I did not tell her my thoughts: following spring break, it was only six weeks till summer, and from there, just four years till graduation, forty till retirement, and just a little while before we get to die.

Now, with the pain and bleeding, I can’t help wishing away work days. Teaching exhausts me. The only part of the day I enjoy is my bedtime ritual. It starts with a bath. The warm water uncramps my gut, washes away the blood. After the bath, I plug in my heating pad and lie down beside Wade. We hold each other and watch something innocuous on TV. Often, Gabriel joins us. I’ve gotten to love the Home and Garden Channel. People choose and buy houses. Sometimes they fix the houses up. No one is sick or in pain. Often, the houses are located in lovely places, like Hawaii.

•••

A week after my biopsy, Dr. E phones. “I’ve thought about your case. You have two options.”

Option 1 is a second D&C, this time using a camera called a hysteroscope, so the doctor can pinpoint the exact location of my problem and remove the cause.

“Option 2 is an ablation,” Dr. E tells me. “It means removing the lining of the uterus. Take a few days to decide which you prefer.”

I research the web and talk to Wade. In the end, I tell the doctor I choose the D&C, the less aggressive procedure. Why rip apart my uterus when I don’t know what’s causing the problem?

“But a D&C isn’t one of your choices,” the doctor says. “It didn’t work last time!”

“But you said you’d use a camera—”

“I don’t think so,” says Dr. E. “Your options are an ablation or a hysterectomy.”

My breath stops. Could I have gotten this wrong? Yet surely I’d remember if she’d said hysterectomy. The word sends a chill through my body. How can this doctor suggest removing my uterus or its lining without knowing what my problem is? And how can I trust her with my body if I can’t trust her to remember her own words?

I have no idea what to do next. But the bleeding and cramping keep getting worse. I’ve got to do something.

•••

I hear about a therapist offering a workshop for people with chronic and/or terminal diseases. I figure three months qualifies my problem as chronic and sign up.

“You are in charge of your healing,” James, the therapist, tells us. He does not say to distrust doctors or medicine, but rather that each of us should stand vigil over our health professionals, since we are the experts on our bodies.

“Get a second, third, and fourth opinion,” James advises. “Use different types of healing. When my wife had cancer, she worked with Western doctors but also consulted an acupuncturist.”

I tell James I don’t have the strength to do what he suggests. He says that’s the hard part—no one with a chronic disease has energy. “But have your current doctors helped you?”

“Not really.”

“Then you need to fight.”

•••

I go back to Dr. D and ask her to recommend another gynecologist, and she refers me to Dr. F. I send Dr. F my chart, now two inches thick, along with a note detailing the past four months.

“How terrible!” Dr. F tells me during our consultation. “I’m so sorry you’re going through this.”

I heave a sigh of relief, hold back tears of gratitude. She’s the first of my doctors to express empathy.

After looking at my record, Dr. F asks two questions: “When Dr. C performed your ultrasound, why didn’t he use a contrast dye? And when Dr. E did the endometrial biopsy and D&C, she got no tissue, or as good as none. How can she say you don’t have cancer?”

“Do you think I have it?”

I remember the day I learned about this disease, in seventh-grade science.

“When a person gets cancer, some of their cells go bad and start to kill the good cells,” Mr. Ringel, the science teacher, told us. “More and more cells turn cancerous. The process doesn’t stop until the host is dead.”

Host? A host welcomes guests. How can we use the same word for a body invaded by rogue cells? And am I now harboring this illness that killed my grandparents and later struck my mother and her siblings?

“You’re probably okay,” the doctor says. “But if you were my patient and I had such little data, I would not feel safe assuming you didn’t have it.”

The doctor recommends another D&C. Since she no longer performs surgery, she refers me to her colleague, Dr. G.

Dr. G can’t see me until December 19—a month away. When he finally examines me, he concurs that my uterus is enlarged and a second D&C is warranted.

“Good. Can we do it this week?”

“Unfortunately, my schedule is packed, and with the holidays, we’re short-staffed through New Year’s. I can schedule you for January 9.”

I bristle at his banalities: schedule packed, holidays.

•••

Dec. 22. A bunch of us are grouped around the breakfast bar at friend’s Christmas party. A skinny, bespectacled guy, a friend of the hosts, says, “Did I ever tell you how I killed my first patient?”

We all prick up our ears.

“So, anyway,” Dr. Skinny-Bespectacled says, “I’m twenty-five, I’m a resident, and I’m a real idiot, you know? They’ve got me paired up with this other newbie, Fred. They send us in to—I dunno, do something to the oxygen tube on this guy—the guy was thirty years old and dying of cancer, right? A real tragedy. So anyway, no one tells us how to do this thing, we’re both falling over ourselves, then all of a sudden, Fred says, ‘I think he stopped breathing.’ It was awful. Now you’ve gotta bear in mind that this guy probably wouldn’t have lived much longer, anyway—”

In my head, something kills the volume on the conversation. All I hear are doctors’ voices: Cora Schenberg’s death was a terrible tragedy. But of course, she’d have died anyway.

•••

If offered a wish now, I’d ask for time to speed up. I want the surgery done. But time has slowed to a standstill. It creeps toward Christmas, fa-la-bleeping-la. My family and I hide away from the stores, the hysteria. Wade and I are too tired to throw our usual Hanukah party. On Dec. 31, we’re all asleep before midnight.

•••

January 8, 2013. The night before surgery, the cramping increases. It feels as if something is fighting to get out of my belly. In the morning, I’m filled with relief as we drive to the hospital.

Wade is waiting when they bring me back from the OR.

“The doctor just left. He wasn’t able to complete the surgery.”

“What?”

“He said he got in there and nothing looked like in the ultrasound. He was afraid he’d punctured your uterus and gone into a false channel.”

I don’t know whether to cry or curse. False channel. Cul-de-sac. My body is not a road!

“So what’s next?” I ask Wade.

“The doctor’s going to consult with some colleagues and call you on Monday morning.”

Dr. G does not call on Monday morning. That afternoon, I ring his office. The receptionist tells me he’s out of town. Which words to choose so that this woman will hear me and make sure the doctor gets my message?

“I was in menopause for four years,” I say. “Six months ago, I started bleeding. It keeps getting heavier, and I’m in constant pain.”

“That’s awful!”

“It would really help me to know the doctor’s plans.”

Tuesday morning, Dr. G is still out of town. I leave another message.

By Wednesday morning, I’m desperate. I’ve had to buy yet another family-size box of feminine hygiene product. I know it will just make things worse if I call and yell at the receptionist.

The phone rings; it’s Dr. G. After apologizing for his long silence, he says, “I just got your report back from the pathology lab, and I’m afraid the news isn’t the best.”

Wade steps into the room just as I repeat the doctor’s next word: malignancy.

“You’re saying it’s cancer. What kind? What stage?”

“We don’t know. It’s in your uterus or your cervix, maybe your ovaries. I was surprised there was enough tissue for them to find anything. We’re sending you to the cancer center at the University Hospital. They’ll take care of you from now on.”

I hang up the phone, run into Wade’s arms. I try to feel the warmth of his body, but I’m frozen in panic. I think of all the months wasted, going from doctor to doctor. I remember my friend Mary, who developed symptoms like mine years ago. Mary’s doctor diagnosed her with fibroids, prescribed a painkiller, and said to come back every six months for monitoring. One day, a mutual friend called to say Mary had cancer. Rather than presenting, Mary’s cancer had slunk in silently and set up camp. Free from a doctor’s intervention, the twisted cells multiplied until they pushed past the walls of her uterus and laid claim to Mary’s lungs, heart, and back. She was dead six months later.

“I hope those doctors haven’t killed me,” I say, into Wade’s shoulder. I suddenly remember a cartoon the New Yorker ran just after Mary died. It showed a doctor in a lab coat, doing a silly dance. The caption showed what the patient on the exam table was saying: “Sounds like dance? No, dancer! Cancer! I’ve got cancer!” At the time, I wondered if Mary would find this cartoon funny or think it the most tasteless thing in the world. Since I wasn’t that patient, I thought it wasn’t up to me to say. But now I am that patient, and I hope Mary laughed, because I think that cartoon’s funny as hell. I hold Wade, laughing and crying, until it’s time to leave for work.

•••

February 5, 2013. The instant I meet my oncologist, Dr. Cantrell, time speeds up. Dr. Cantrell looks no older than twenty-five. A slender woman with a brown ponytail and a big, toothy grin, she shakes my hand with a strong grip. After hearing my story, she says, “I’m so sorry you had to go through that. Sometimes even very good docs miss these things. Now, the first thing we need for you is an MRI.”

“When?” I ask, expecting the usual wait.

“When do you get done teaching this afternoon?”

“At two.”

Dr. Cantrell turns to her nurse, Peggy. “Schedule Ms. Schenberg for an MRI after 2:30 today.”

Noticing my expression of disbelief, she grins. “You’ll find things move pretty fast around here.”

A week later, Dr. Cantrell calls with my results.

“Your ovaries and cervix are fine; the cancer’s in your uterus. I recommend a hysterectomy. Can you clear your schedule for surgery on Tuesday?”

“I’ll call my boss now. How much bed rest will I need?”

“Most people go back to work in a few days.”

“How–”

“In most cases, I make a couple of tiny incisions, about a quarter-inch long, then I can remove the uterus vaginally. It comes out like a baby.”

No! I want to protest. Not like a baby. My baby filled me with awe. My baby did not try to kill me.

“Now, sometimes,” Dr. Cantrell continues, “the uterus gets enlarged from inflammation. If it’s too large to remove vaginally, I’ll have to make an incision. That recovery can take four-to-six weeks.”

I say nothing to this, my head still swimming

Before hanging up, Dr. Cantrell teaches me three new words: Endometrioid. FIGO. Clear cell.

After surgery, she’ll order a pathology report. If I have endomitrioid, FIGO grade 1 or 2, my tumor will be classified as slow-growing and non-aggressive, and require no treatment beyond the hysterectomy. However, if clear cell cancer—grade 3—is present, I’ll need chemo and radiation, too.

“Clear cell,” I repeat. These words sound so innocuous. But on second thought, clear cells would be the undetectable kind that sneaks up on an unsuspecting host.

•••

Gabriel joins Wade and me in our bedroom as we watch television.

“Mom,” he says, “I know you don’t want to make this cancer thing public. But is it okay if I talk to my really good friends?”

“Of course,” I tell him. “I’m taken care of. You and Dad need all the support you can get.”

•••

February 12, 2013. The orderly wheels my stretcher into the operating room, where Dr. Cantrell, already wearing her mask, greets me with a hug. Waiting for the anesthesia to work, I place my hands on my lower belly, murmur a silent good-bye to my womb.

I wake to whispers. Someone repeats one word several times before I realize it’s my name and look toward the speaker.

“Your surgery went well,” Dr. Cantrell says. “It looks like stage 1—no sign that the cancer spread. I’ll get your pathology report back in a week or so.”

“It hurts.”

“Unfortunately, I had to make an incision. It’ll take a bit longer to heal, but you’re in great shape. You’ll be fine.”

Flowers, care packages, and cards are waiting when Wade brings me home from the hospital. Gabriel hands me a stuffed penguin he and Wade got me at the hospital gift shop. Friends from the synagogue tell me I’m on the prayer list and ask when they can come by. My sister Kathy arrives to visit and shop and cook for us.

A week later, Dr. Cantrell phones.

“Cora, I’ve got your report.”

“Good news, Doctor?”

“Remember I told you about those three kinds of tumors? I’m afraid you’ve got clear cell–a grade-three.”

The room turns sepia. I struggle to find my voice. “What happens next?”

“We’ll give you time to heal, then, if you agree to it, we’ll start chemo and radiation.”

“How come I need both?”

“This is all based on studies. The latest ones show that when the cancer returns, it usually comes back to the same site. So we radiate that area, to kill any cancer cells the surgery might have missed.”

“And the chemo?”

“The chemo will get any cancer that might have spread into your system. I know I’ve given you a lot to think about. Take a few days to decide what you want to do. Call if you’ve got questions. I’ll support any decision you make.”

Wade, Gabriel, and I sit around the table, not speaking. I try and fail to feel the warmth of their presence or register the soft light from the lamp above the table.

•••

Dr. Cantrell teaches me more new words. The radiation she prescribes is called brachytherapy–placing the radiating source near the former site of my tumor. She explains that with the radiation confined to a small area, I shouldn’t expect side-effects. Yet what I hear in the sound of “brachy” is “break” and “broken.”

I have to train my mouth to get around the words Carboplatin and Paclitaxel, the chemo drugs Dr. Cantrell would use. Their syllables feel arbitrarily thrown together, like bad architecture. Dr. Cantrell does not hide the fact that chemo is poison. While it kills cancer, it also attacks other fast-growing cells, like those in the stomach lining and hair follicles. It wipes out both red and white blood cells, disabling the immune system. I’m reminded of generals who hire mercenaries—thuggish louts who wreak havoc, but get the job done. I sign off on both the chemo and radiation.

•••

February 25, 2013. I’m off from work for at least another month. The chemo and radiation won’t start till April. Meanwhile, healing takes place in the silence that fills our house when Wade and Gabriel leave for work and school. I depend on my body to tell me when to eat, sleep, poke my nose outside for air, and sleep again. From my rocking chair in the living room, I take in butter-yellow walls, a glass-fronted bookshelf holding our favorites, and three cats asleep on the sofa.

I don’t yet know that in September, when my family and I join the congregation for Rosh Hashanah, I will be pain-free, my scar a faint line. That Dr. Cantrell will call me her star patient and say to come back in four months instead of three, since everything looks so good. For the moment, I’m content not to know this. To let time to do what it does, without expanding or contracting, speeding up or slowing down. I’m grateful to rock in my chair, as the winter sun strengthens.

Note: Some names and physical characteristics have been changed to protect privacy.

•••

CORA SCHENBERG’s work has appeared in Brain,Child, Utne Reader, the Delmarva Review, C-ville Weekly, and The Hook; she has also read essays on WVTF radio (NPR Roanoke) and had three plays produced in Charlottesville’s Live Arts Theater (Summer Shorts Festival). She holds a Ph.D. in German literature from the University of Virginia, where she currently teaches.

To the Pain

crystalball — By Beth Hannon Fuller www.studiofuller.com

By Dina Strasser

Mandolin? Mandoline? I’ve never been able to figure out the pronunciation of this device or how it connects to music. I have angered it. It has just sliced lengthwise through my right thumb.

I have been battling a series of small but debilitating injuries since I hit my fourth decade—an ankle orthoscopy, plantar fasciitis, arthritic knees, unexpected bursitis in my shoulder. It’s old hat now. Maybe this explains why my first thought is the purely prosaic: “Fuck. Now I can’t finish dinner.”

But there the potato sits, half scalloped; there is the mandoline, so swift and clean in its retribution that I do not bleed until several seconds after I hang my thumb under the running faucet.

The water begins to turn a deep shade of rose. Anthropomorphizing the mandoline is a bad idea. Inaccurate. I turn my hand over, gingerly, and see that there is no flesh behind a portion of my thumbnail.

The shaking starts.

“Honey?” I call.

•••

I have slung my teacher’s bag onto my single shoulder, often dozens of pounds, unprotected, for over a decade. In a misguided fit of back-to-nature, I spent a summer in “minimalist” sneakers, not realizing that my tendons weren’t strong enough to handle the strain. And what preventable loss of focus drew me away from noticing where my fingers had gone today?

Surely, as with all truths, the reality is a confluence of things both within and outside of my control, but I realize as I clutch the bloody paper towels around my hand that this doesn’t matter. I have already decided that I have not earned the right to cry.

I take deep, shuddering breaths over and over as I sit in the lobby of the urgent care facility. “I can’t scare the kids,” I keep thinking, although the kids aren’t there.

My husband negotiates the paperwork.

“You have to sign these,” he finally says, grimacing.

“Seriously?”

The irony makes me laugh, softly, and then a little hysterically.

I grip the pen between my index and middle fingers and, by the fourth form, I have managed something like my name.

•••

“I am not going to be your friend right now,” says the nurse and briskly dumps a syringe full of saline onto my thumb. I am glad my husband is still outside finishing up the papers, so he doesn’t hear my swallowed scream.

A doctor pauses only long enough in the exam room to assure me that I have not damaged any nerves or tendons, that nothing drastic is needed for healing, and to explain that they will place a special foam on my thumb to stop the bleeding. “Okay?” he says. His mouth smiles, and his eyes say, “Now is when I need to smile.”

“Okay,” I say, and he has left before the second syllable hits the air.

The nurse, my husband, and I joke about “Carrot Guy” who came in just before me (now dubbed “Potato Girl”) as the nurse binds me tightly with a pressure dressing and compliments me on my pain tolerance.

I’m grateful. Really. I’ve seen a few doctors recently, and I’m grateful for them all, no matter how busy they are. I try to catch the nurse as we leave, but he wishes us a cheerful goodbye, determinedly eye-contactless, and starts rapidly wiping up the drops of blood I have scattered on the floor. It’s six o’clock, and the office is closing.

My husband scoops up the mandoline the minute we get home. It was expensive, but I don’t feel the slightest bit unhappy about watching him pitch the whole thing into the garbage can, scalloped thumb slice still stuck to the underside. We agree that you’re better off with a plain old knife. You can see where it’s going.

•••

Three days later, I find out what I did to myself officially. It’s Ingrid who tells me, my primary care doctor. She’s unhappy, in the way doctors are unhappy who don’t want to besmirch their colleagues.

“They didn’t give you bandages that wouldn’t stick to the wound?” she says lightly but frowning. The nurse who took me in said something similar but far less diplomatically.

Ingrid has just come back from seeing the patient scheduled after me, allowing me to sit in an examination room and soak the dressing off my thumb in warm salt water. It takes almost an hour. I’ve had to work at it, pulling gently, literally asking my skin aloud to let go of the material and hoping that no one can hear me. The wound is reopened and throbbing out little tendrils of blood into the water by the time it agrees.

I’m disoriented by Ingrid’s question, because she’s staring right at me and typing into her health care software at the same time, without looking at her fingers. It hits me belatedly that she’s doing this on purpose, to make sure I don’t feel sidelined by what her hands are doing.

“It’s called degloving, what you did,” she says. I laugh until I realize that she is using an actual medical term. I am struck by its poetry.

She fills a bag with non-stick gauze, soft antibiotic ointment, and magical bandages that are impregnated with Vaseline, and she redresses my hand. She takes her own right hand and wordlessly rubs my knee for comfort.

•••

I am turning in a tight circle, flapping my arm around as I try to shake off my bathrobe.

“Ah! A penguin in need of assistance!” says my husband, in the plummy tones of Superman.

I grumble wordlessly as the robe drops off my wrist just as I was about to take him up on his offer. As a pair mismatched almost exactly by a foot (I’m five foot three), we have evolved a silent vocabulary of gestures to indicate when I could use a taller person to step in. Standing forlornly in the kitchen with my hand floating in midair means, “Please get that damn coffee mug off the top shelf,” for example. Approaching him silently from behind with a light bulb is also effective.

Today, though, I unequivocally need him not because of my bathrobe, but because I can’t hook my bra straps together. It’s one of those tasks, I discover, which demands working opposable thumbs. I am more and more aware of these kinds of minute movements. I collect them, the way I used to collect small semiprecious gems in grade school. The heel kicks back to close a door when my hands are filled. The fingers hook the collar of a t-shirt to toss it up over the head. The shoulders, astonishingly, comply. Garnets. Rose quartz. Fool’s gold.

My husband, with fingers too large for these delicacies, is fumbling with hooks and eyes. “How do you people do this?” he mutters.

But he was the first to gently pull away the bloody paper towels and just as gently shoo the kids to the neighbors’ house and bundle me into the car. He reached across the seat and buckled me in with the same calm as when he held my hand, almost a decade ago, while I contracted blindly and endlessly to bring our two babies into the world. He saw both resulting c-sections performed behind the curtain placed in front of my head. He was too tall for it to obscure the view.

I finish my ablutions in the bathroom, wrapping up my thumb, lower palm, and wrist with the magic Ingrid bandages, then gauze, then cloth tape.

When I am finished, I open and close my four free fingers over the resulting thick tube for several moments, as if I am making a shadow puppet duck. This shape is reminding me of something, but it takes a while to bring it back.

It’s mittens. I remember suddenly, out of nowhere, how I would stay out for so long on snow days that ice would coalesce into small hail-like balls on the knitted wrists, with strands of wool as their nuclei. I remember the gritty feeling of the wool scraping across my mouth as I took off the mittens with my teeth.

•••

My eleven-year-old daughter has just ripped open a package of litmus papers we’ve ordered for her school science fair project—she’s cleaning pennies with solutions of varying acidities. Once she discovers the rainbow of results, however, she becomes an unstoppable cyclone of litmus testing.

“Oh! Orange juice!” I hear her gasp, and the fridge door rattles open.

I am deciding at our laptop, after a long internal debate, that I’m going to post about my accident on Facebook. I’m preternaturally sensitive to sounding like I’m whining on social media.

I don’t define “degloving” in my post on purpose, hoping people will feel its weird beauty as I did. This turns out, amusingly, to not have been the best idea.

“WORST.GOOGLE.IMAGE.SEARCH.EVER,” a friend responds.

“What else, what else?” my daughter ruminates out loud. “Hair spray!”

“Oh god, it’s not that bad,” I type back, after seeing for myself what “degloving” brings up.

“Bleach!” my daughter sings out.

“Wait, hang on, you don’t have—” I call to her, but she’s already flung herself down into the basement where we do our laundry.

I lurch up from the computer and down into the basement after her, thinking to find her some latex gloves to use. She’s perversely saddened that we don’t have enough corrosive bases in the house for her to get the deep plum shade of the higher numbers of PH.

I don’t find gloves. She could care less. She brightens when she discovers that at least in the PH world, there appears to be no difference between slamming a glass of cranberry juice or one of red wine vinegar. This is good to know.

On the way back up from the basement, I pass the shelf where we store our less-used cooking contraptions. My eyes pass over the standing mixer, the apple peeler, the cherry pitter, and I shudder. I realize that I have now renamed this shelf in my head “Things That Can Hurt Me Really Badly.”

What is getting older but a yawing, a slipping and widening, of that shelf to hold more and more things? Pots. Pans. The stairs. My ankles. Ice. My blood pressure. My brain.

I look down at my hand. How on earth am I going to do this?

My daughter tears off another strip of litmus paper. “Maybe I can spit on it,” she says thoughtfully.

I can’t help it. I laugh, loud and long, and she joins me.

•••

Just before I go to bed, I notice there’s a new comment on my Facebook thumb post. It’s from Rachel, an old college friend, whipsmart and wonderful.

“This is why we don’t own a mandoline,” she writes. “Or a mandolin, which is what autocorrect wants me to own.”

At least I’m not the only one. As I settle down to sleep I picture a clueless, cartoon Autocorrect and I, with a potato in one hand and a mandolin in the other, looking confused.

I cradle my bandaged hand in the crook of my left arm. I’ve re-wrapped it once more, once a day, as Ingrid showed me. “Don’t roll over on it,” my husband says sleepily, already in bed. My daughter is reading quietly about bacteria cultures in her room. The ibuprofen kicks in.

You’re not always going to see where the knife is going. Sometimes you’re going to look for a stringed instrument to make music, and find it is a bloody blade instead.

But what else is there to do? You reach out. You strip off your gloves. You play.

•••

DINA STRASSER is a language arts educator of many stripes. She has been published in the New York Times, The London Times Online, and Orion Online, and she runs an award-winning blog on education at http://theline.edublogs.org. This is her second essay for Full Grown People.

Hope Floating

By Robin Schoenthaler

I was forty, and single, and pregnant, and jubilant. I blossomed during a perfect pregnancy and then proceeded to give birth to a beautiful baby boy I named Ryan Peter Schoenthaler, eight pounds twelve ounces and twenty-one gorgeous inches long. He died nine days later in my arms, still and cool.

I buried that boy on a sunny hillside in a tiny casket designed to look like a bassinet, and by the time I stumbled out of the cemetery, I was a dead woman walking. Some days I couldn’t keep my eyes open; other days I could barely speak. I dreamed in adjectives: impossible, unbearable, unimaginable; I woke up with verbs: pulverized, imploding, eviscerated.

Two years later, I gave birth to a boy named Kenzie James. I got through the pregnancy and birth through denial, plain and simple, with one permanent pricetag: nine months of total amnesia. Of that period of pregnant pause, I remember OJ Simpson and I remember grinding my teeth, and that is really all.

Three miscarriages and three years later, when my last son came along—Cooper Craig Schoenthaler—I was wholly awake and fully attentive and I remember everything. Of the six pregnancies, I am left with one birth story.

Cooper was delivered by Cesarean section. An average C-section takes six or seven minutes from incision to delivery; Kenzie’s took an endless half-an-hour; Cooper, eleven minutes. Eleven minutes to a lifetime.

I lay there while they opened me up again, floating along the arc-line that had gradually and irrevocably led me to this scene—lying flat on my back in a yellow room with bright lights. I was a woman physician under the care of women who started out just like me, women who struggled over books and tests and money and hostile men in positions of power for years at a time and who now put their bodies and souls on the line.

I remember my obstetrician Sharon coming to my hospital room at midnight to attend Ryan’s brain-dead baptism. I picture her holding my hand in the NICU that night and then again and again over the next five years. I think of all the phone calls: I would sob and she would let me make any appointment any time as I worked through the surviving of survivorship.

I think of all the tables I have laid on and all the doctors I have seen—a long line, a stately procession—giving me good news and bad news and no news at all. I think of Ryan’s delivery and his death. I think of how I lifted his body straight up above me, offering him to the sky. I think of Sharon two years later holding Kenzie aloft, in triumph, a giddy elevation of child-spirit, a peak moment, a crystal. I think of the dim light in Ryan’s NICU room where his soul sailed away, and the bright lights in Kenzie’s delivery room when his soul sailed in.

I think of the night light that Kenzie uses—how at three he is already such a singular little person who wants to look at books alone at night, how his soul is full of light and always has been. I feel the presence of both Kenzie and Ryan very distinctly within me, as well as a whole line of women who have given birth before me—my grandmothers and my friends, my mom and all the bereaved women in books and on buses.

I listen to the heartbeat monitors and think of Ryan’s heartbeat ceasing and Kenzie’s frantic heartbeat when he’s feverish and the roaring in my ears each time I miscarried and I can’t help but compare them to the steady beat-beat-beat that is my own heart’s rhythm in this room at this moment.

It’s a long eleven minutes.

Then I hear Sharon start to croon. In seemingly an instant, she again holds one of my sons aloft in the light. The overhead lamps create an aura, a halo, an embrace and I experience blindness reversed as the light heightens every pore and every limb and Cooper is outlined in beauty, screaming shrieking bloody beauty. He is alive, he is aquiver, he is a soul.

They bring him to me wrapped up and warm. I get my first good hard look at him: he is red-faced and dumbstruck, and I am the same.

I reach for him. No one says a word. The room is quiet; it feels like an altar. There’s no heart monitor machines now, no barking loudspeakers, just the murmuring of Sharon and her partner, and the nurses counting sponges. I kiss Coop over and over—his perfect cheeks, perfect skin, perfect neck. He turns to me when I speak.

I lay there with this miracle in my arms, flooded with all that can happen over the course of half a decade. I remember the long period after Ryan’s death when a pain-free interval seemed impossible, when anguish never ended and never waxed or waned.

But I realize, lying there, that somehow, somewhere, something carried me through. It is too strong to call it “hope”: there was no hoping back then. It’s too strong to say it was anchored in me—it was not. But it must have floated, in and out, with the moon, or with the seasons, or maybe with each breath.

Because something helped me hear the muffled words that sometimes bounced off the sheer rock cliffs of my pain. I began to hear the voices in the cemeteries I visited—voices of mothers who murmured that if I could just keep breathing long enough the tunneled darkness might begin to lift. I began to see the anguish of my cancer patients in terms of cells defying death. I began to connect myself to a humanity bound up with suffering—plague victims, war dead, road kill, religious martyrs, and most of all a long line of women who had keened over children in caskets.

Something had taken hold of me. It wasn’t optimism or confidence or faith in an equitable universe—that was gone and would never come back.

It was much fainter: a tiny turning, a whispered murmur, a miniature red berry lying deep and dormant. But the berry dropped a seed and the seedling took. A tiny bud appeared and on it there must have been a drop of dew, and that was where I let that little thing that must have been hope float. I never touched it, I never named it, I really never even knew it was there. I just let it float. I let my hope float. I let my hope float on an impossibly tiny bud and now I had another son, I had two more sons.

They move us to the recovery room where it is dimly lit and quiet. Cooper nurses. I am pain-free and at a level of peace that is hard to describe to this world. I curl up on the gurney in the darkened recovery room, all dreamy sated senses.

Eventually the nurse and I begin to chat. She remembers Ryan well. “Every time I pass Room 428 I think of all the flowers you left behind,” she tells me. Then we coo about Cooper, how beautiful he is and already such a good nurser and so alert and connected and smart.

She tells me then about her own difficulties with conceiving, her doubts and how frightened she has become. I can so completely relate to this young woman at the beginnings of yet another long trail. She says to me, “We’ve tried so hard to have a baby, but I’m afraid to keep trying. How did you keep your hope alive?”

I start to tell her, but I hesitate. I’m suddenly tired beyond imagining, my eyes and limbs feel weak and I am nearly asleep. I murmur, “Just let it float.” She says, “Hope Floats? Isn’t that a movie?” and I giggle into the pillow.

Lying there laughing, I feel them like a flash flood, the raw and precious lives that led us here: the lives where pain has a beginning but anguish has an end, where seasons start and berries fall, where there are voices that can pierce the darkness and where cells that split can mean life in one year and death in the next and where there are webs that connect us with our ancestors and that in the darkest winter there are buds that can act as cradles and that hope may not spring eternal but that it can absolutely float.

•••

ROBIN SCHOENTHALER is a writer/mom/physician (the order varies by the day) who lives outside Boston with her sons Kenzie and Cooper. They are now seventeen and fourteen, and Ryan, had he lived, would be a freshman in college. Her website is www.DrRobin.org.