“Mass General” by Gary Campanella


Amy and I are barely talking. Since my decision to bring Mother home, and not to hospice, a decision that Amy thought a mistake, we’ve settled into separate routines. And a lot of silence. We wake at different times, make our own meals, and sleep in various rooms. When we talk, we talk about errands, or bills, or how Mother looks. We keep a corkboard with notes for doctors or nurses or anyone who calls and leaves a message. We are not fighting, like so many have implied. We are distracted.

We are also grieving. Whoever said that is right. But I am still shocked to learn that we don’t have each other to lean on. I think of Amy and me as people who come together in times of crisis. But we aren’t.

One day crashes into the next. I sit by as Mother, closer really to Amy than me, strains to fight the disease that is crunching her lungs. She is losing. I wouldn’t say she is giving up. I’m not even sure what giving up, while lying in a bed, hopped up on pain meds and hooked up to oxygen, even looks like. But she’s not doing well.

Neither am I. I’m a sad, worn-out zombie. I spend most of my free time alone, watching TV, or sleeping in front of the TV, with the TV watching me. Late last night I woke up on the couch and watched a rerun of an old cop show. I cried stupidly at the sadness of it all.

Amy is also struggling. She spends her extra time at work, or running errands that don’t need running, or talking on the phone with her friends. She misses Mother. Before she got sick, the two of them talked every day. Mother is mostly sleeping now.

***

Today her lungs stopped working. The home health nurse was there, and they rushed her to Mass General. Amy was home and followed the ambulance. I was out and met them there.

They have her on a ventilator and tell us to expect the worst. Today is my birthday, a week before Christmas, but that ain’t neither here nor there. Mother is sedated and she looks different, like she’s got one foot out the door. I have to turn away. She’s unconscious but stable and so Amy and I drive home in our separate cars to our house with our undecorated tree. I stop to pick up a bottle of wine. I buy Amy’s favorite. When I get back, she is sitting at the kitchen table with her coat still on. She looks tired. We talk about the breathing machine not being as loud as we thought it would be. She says, “We should turn it off.  The doctor says we should, and she’s suffering.”

“I think she’ll suffer more without it.”

“I’m talking about her dignity. I’m talking about that look in her eyes, like an animal caught in a trap.”

“I didn’t see her awake, but I get what you mean.”

We go back and forth until I say what she knows I am thinking. “I want it on until Matt gets here.”

Amy holds her face in her hands. She’s angry. She says, “He’s probably not coming Dan.”

“She’s his mother. He’ll come.” 

 Matt still lives in California. He has not come back since Mother got sick. Matt and Amy never warmed up to each other, and Matt’s absence hasn’t helped. Amy tells me Matt doesn’t deserve the chance to see her, not at Mother’s expense. She’s probably right, but still I disagree.

And, because she is my mother, I win.

***

I pick up Matt at Logan Airport. It’s cold here. December. Steam rises from the factories across the bridge. City smells hang low to the ground.

He gets off the plane with Toni, who he has lived with for over a year. This is the first time I knew she existed. Matt is 38 now, three years younger than me. I don’t think Toni is 25.

I knew he would come, and I know why he didn’t come before. This is the shared knowledge of family, of blood, of people who grew up together. It is the mystery I didn’t try to explain to Amy, who has no brothers or sisters.  Mother always understood. “That’s Matt,” she said when she could still talk, forgiving him. Amy is not as forgiving. She has been badmouthing him frequently. She thinks I am too accepting of his flighty, absent behavior. She is right, at least from her perspective.

Matt and Toni are dressed for an LA winter. They are freezing and disheveled from the red-eye flight. Matt and I shake hands. We embrace but say little. Toni says nothing. She looks shy and worried about Matt. I like her before she’s introduced. She’s composed and solid, unlike Matt, who looks like he’s falling apart.

Amy is at the hospital waiting for us. Her arms are folded across her chest like she does whenever she’s mad or impatient, and she barely acknowledges Matt. She eyes Toni up and down, and I see she doesn’t like her. She doesn’t say anything, but I can tell by the way she looks past her.

Matt walks past Amy without speaking and into the room. Toni and I follow. Matt staggers when he sees Mother. Toni catches him. “How long?” he asks me. His voice is a whisper, barely audible.

“Not long once they shut the ventilator off.”

“Does dad know?”

“He knows enough. I’ll call him when she passes.”

“Where is he anyway?”

“This time of year? The house in Florida. I haven’t talked with him in weeks though.”

***

Matt is far more of a mama’s boy than me, though most people think the opposite. Most people think that when Matt left town, moved to California, and never came back, that he abandoned us. People say he sides with our father, that he blames her for whatever went wrong in his childhood. Mother’s done nothing to dispel that. She couldn’t care less what other people think. She maybe felt hurt, but she never said so. What people don’t understand is that she never thought Matt should stay in Massachusetts. People notice that she hardly ever mentions him anymore, but I think that’s because she misses him. He is her favorite.

And as for Matt, he didn’t move away from Mother, he moved to California. When he first moved there, almost twenty years ago now, he would call every week. But, when things started happening for Matt, that once a week turned to once a month, then once every few months, then even less. It wasn’t intentional and I know he’s always felt guilty about it. He’s told me that. But he was busy building himself a life at first, and then he got one, and then that kept him busy. Mother understood that. I did too.

***

“When do we shut it off?”

The heater buzzes and hot air hisses into the room and creates a smelly and stifling humidity. Toni sits on the empty extra bed in the room. She’s tired from the flight and the cold trip from the airport to the hospital. The room is filled with turned off medical equipment, like they stuck my mother in a supply room. The only stuff that’s on is the ventilator and the thing that watches her vital signs.

“Whenever you’re ready,” I say.

“I’m ready,” Matt says. And he means it.

I leave Toni and him alone with her for the last time. I don’t kiss her or say goodbye. These things are done. Amy meets me in the hall, and I see that she’s irritated, “Well?”

“Tell them we’re ready.”

“OK,” and her eyes go soft. She grabs the two little fingers of my left hand and squeezes, our most tender gesture in weeks.

Nurses arrive, confirm with me, go into the room, and Matt and Toni come out. They’re both crying. Matt gathers himself and walks up to Amy and gives her a quick embrace. He steps back. “This is Toni,” he says, moved and proud.

Amy looks Matt straight in the eye and says, “She looks like she’s twelve, Matt.”

Matt stiffens, meets her gaze, and turns away.

I say, “Jesus, Amy.”

She turns to me, turns on me, says, “Go to hell,” and walks down the hallway, away from the room.

Matt turns, puts his arm around Toni, and they walk past me, past the room, and out of the ward.

***

I sit by her bedside while Mother dies. Is it ever supposed to be like this? Almost alone after a life filled with others?

It doesn’t take long. It’s late afternoon when the head nurse, a woman about my age, Jamaican, heavier than me but who moves across the room with grace and purpose, with a calm urgency, taps me on the shoulder. I’ve been watching her come and go for hours, before Amy stormed out, before Matt and Toni came and went. She moves between Mother’s room and other rooms, and the oval station the nurses use as home base. There are other nurses too, and various orderlies and maintenance people, and even an occasional doctor, but this one nurse is the one I see the most. Her first name is Cheryl. She walks straight to where I am slumped in a chair. She pauses while I meet her gaze, then takes a deep breath and sits down next to me. “Your mother is passing onwards now.” Her phrasing strikes me as odd. She stands and watches me and waits for my response. Your mother is passing onwards now. The words get stuck in my ears. What a strange and singular moment hearing that sentence.

I look away when she says it, but then I return my eyes to hers. They are kinder than I remember from a moment before, more sympathetic than I expect. “Thank you.”

I make my way to Mother’s bed, and I kiss her on her forehead. I tell her I love her. I tell her I am proud to be her son. She is unconscious, and her breathing is deep and loud, and very slow. There’s a long build up to each breath, a heaving in her chest and throat, as if her lungs are a motor trying to start in the cold. When she catches her breath, her inhale is sharp and loud, very quick, and is followed by an equally fast and audible exhale. In between it is quiet. She’s only taking about two breaths per minute. Her heart rate is also low. The machine that monitors her vital signs is in alarm. Cheryl shuts off the tone.

I stand by her bedside for a long long time. I wait for each breath, hoping for it, but dreading the discomfort it seems to cause her.

I wonder where Amy is. I wonder where Matt and Toni are, though I’m pretty sure they left. Matt said his goodbyes, and we all know he’s not one to linger. I wonder when I’ll see him again. I turn to ask the nurse to find Amy, but I am alone. Just Mother and me. I look toward the door and see Amy standing in the hallway, her short brown hair messy and tears streaming down her face. She looks younger. Beautiful. I motion for her to come in, but she backs away, unwilling or unable to join me.

I look back at the strong woman who brought me and then Matt into the world, cared for us alone for most of our childhoods, and dedicated most of her life to us. She was never rewarded with grandchildren. She inhales again, and then a thick, single tear rolls down her left cheek. Her heart stops. I wait for an exhale, but none comes.

I am horrified by the sudden stillness. I am horrified that there is no final exhale, like something is missing, like an exhale is something we both need to finally rest, but will never receive.

And this is the way her life ends.

***

After a minute the nurse comes in and I leave the room. I find Amy crying in the hallway. I put my arm around her. We are not distracted.


Gary Campanella writes fiction, nonfiction, and poetry. He is a 2022 Pushcart Prize nominee and won an Honorable Mention in the 2023 Allen Ginsberg Poetry Prize. His work has appeared in print and online publications. He is Editor of the Muleskinner Journal. He lives on a dead-end street in Los Angeles.