(FYI: There is a spoiler in this review. But I will warn you when to stop reading!)
During the first two days of Kendell's recent hospitalization, he was in that medically-induced coma and on the cooling protocol, which brought his body temperature down to 31.4 degrees in order to preserve the possibility of normal brain function. I alternated wildly—if you asked me what I thought would happen, sometimes I was certain he wasn't coming back, sometimes I was certain he'd be just fine. It was a terrifying 36 hours. Actually, "terrifying" isn't even the right word. It was like...time outside of time. Days spent waiting for uncertain medical outcomes are, to borrow Becky's words, the most boring of alarming time.
You just wait. You just wait for time to pass, and you hope, or you try not to hope, depending.
It's time without any meaning, except for the anxiety and fear, the hoping and not hoping.
Usually I am able to fill empty time by reading, but not those hours. Between texting to keep everyone updated and just being worried, I couldn't keep my mind on a narrative. In fact, one of the nurses (who I have extremely mixed feelings about and will surely blog about again) asked me, when she came into the room and found me texting on my phone again, said "wait, aren't you a librarian? I thought you'd be reading something amazing."
(Actually, I was; I read poetry during those long hours. But "reading poetry" is sort of an invisible activity, certainly not something most people see as amazing. Even though it was so comforting to me.)
Once he was out of his coma and we knew he'd likely be OK, there were still more entire days to spend at the hospital, killing time while we waited for tests and procedures and doctors, but then—the fear of mortality having passed—I could read a novel.
The book I picked out of my enormous pile of library books waiting to be read was Kate Atkinson's A God in Ruins. This is a companion novel to Life After Life, a book I adored and continue to think about. Why the WWII ruminations of a RAF pilot as the perfect book to read during my husband's hospital stay? Because you need comfort reading, something familiar, and while death and bombings aren't exactly comforting, the landscape is familiar. I've read so many books about WWII that a new one usually doesn't feel completely new. Plus, I already knew the characters.
Unlike Life After Life, A God in Ruins tells just one story, the narrative of Ursula's little brother Teddy. I'm not spoiling anything when I tell you that it is the story of both his life during the war and his life after surviving the war, a miraculous feat given that only 10% of the RAF pilots who started flying at the beginning actually survived to the end. That sense is also why it was perfect: Teddy's post-war life is a miracle (as Kendell's post-cardiac-arrest life is), and yet he struggles to find something extraordinary to do with it. As his post-war life progresses (the story flips through time, a chapter about his childhood followed by one about his marriage followed by one about the war), with marriage and a family and a career, he discovers that he didn't make it through the war to live an extraordinary life, but a normal one. It felt like a sort of...warning, perhaps, to me, to not be too grandiose in my expectations for why Kendell survived. Maybe he survived just to live his own, normal life, which is also a thing of value.
On some level, Teddy surviving but then finding a normal life is disturbing. All that death and destruction, all the fear and the near misses, only to bring him to a life of mediocrity? But on a different level, that is exactly the point. The point of trying to win the war (if it could be said that anyone "won") was to give people the chance to live normal lives.
(HERE IS WHERE YOU SHOULD STOP READING IF YOU DON'T WANT THE BOOK TO BE SPOILED!!!)
I was absolutely OK with this direction for Teddy's story. I found myself connecting to his life in so many ways, his difficulty connecting with his daughter Viola but his contentment with his granddaughter; his bookish wisdom; his struggle to let go of his writerly ambitions. I was thinking that the point of the book was to explore the ramifications of this question: is an "average," normal life one with any meaning or worth? (Of course it is.)
But then that ending.
That ending came and I confess: it's a risky ending for me. When Ian McEwan did something similar in Sweet Tooth I was annoyed and disappointed, but I loved it when he did it in Atonement. Atwood did in with Blind Assassin and I had to almost immediately re-read it to understand how all the pieces of real/story fit together. Teddy's post-war life turning out to be just an imagined story, a what if (even though of course it's a novel, it's all what if), and the way the characters who were influenced by his life either also vanished into the imaginary ether or lived entirely different lives? Well. It really is the same thing that happened in Life After Life. It broke my heart but it didn't piss me off because I kept expecting some sort of deviation from the normal from the book, based on its predecessor.
It broke my heart because I wanted Teddy to live.
I wanted him to live the rest of his fairly-normal, average life because that was the point, right?
Except—the ending changed the point altogether. The ending truly made it into a novel about the war, about the horribleness of any war and how no one can imagine how utterly altered individual lives and society and the world become because of war. That one life, not happening: that happened so many times, over and over, because of that war and the earlier war and all the wars. It is almost unendurable to think of it.
Everything about this book made me sad. That title! Teddy's pre-war explorations of France and how they couldn't lead to anything because the world itself was going elsewhere. His image of the coast of France: "The coastline seems composed of solid blocks of colour and hot slices of sunshine." The glimpses of Ursula, who is living a life that doesn't exactly match up with any of the ones described in Life After Life. Bertie's "ragbag of loveliness," which is random snippets of lovely writing that she remembers at odd times. (I do this, too. The way we say the world is what we get.) Nancy's piano playing at the end. More than anything, the way it also says something about writing itself, or the act of creating (or Art, as Teddy's mother would've said) and how novelists make characters come to life so that we mourn we they die, even though they never lived, and all in an attempt to make sense of life. A God in Ruins ends by making you aware of how impossible it is to make any sense of life, either how it ends or how it continues, sometimes impossibly.
Art, Teddy believes "should be a source of joy and comfort, of sublimation and of understanding." Books, I believe, sometimes come into our lives at exactly the right time. A God in Ruins did that for me. It was entirely unconnected to the events in my life, and yet it helped me make sense—brought understanding—to the events in my life.
It was a fairly normal evening: we ran a few errands after Kendell got home from work, we picked up some dinner. We watched an episode of The Vikings while we waited for Jake to get home from his night class and Nathan to be finished at his friend's house; we tucked Kaleb in, we talked to the Bigs about a few different things.
We went to bed.
Kendell woke me up a few minutes after I'd fallen asleep, because his nose was whistling. I nudged him and he mumbled something and then we were back asleep, except maybe that whistle didn't let me all the way back. Maybe I was on alert, in some unconscious region of my brain.
Maybe I have never really felt at peace since his last surgery in October. Maybe part of my sleeping self is always partly awake, listening, because once your husband's heart has been cut open and been pieced back together, maybe you never stop worrying.
We went to bed, and then I hushed his whistling nose, and then he woke me again. I didn’t know what time it was, hours later it seemed, and again it was his breathing, but this time it wasn’t a benign nose whistle. This time it was a death rattle of a breath, a screeching, gasping breath with his face screwed up tight with the agony of trying to get air into his lungs (agonal respiration I later learned, the body’s very last attempt to save itself)
and I was shaking him as hard as I could, I was screaming are you OK? And I knew he wasn’t,
so I was grabbing my phone and calling 911 while I raced around our bed to his side
and then hours
or seconds later the 911 operator was walking me through giving him CPR, I was plugging his nose and taking a breath and then lowering to breath into his mouth and I thought
I can’t do this
and I thought
I’ve kissed his mouth one million times, I can do this
and then I was breathing into his mouth and feeling my own breath only fill up his cheeks
and then I was pumping as hard as I could on his chest
and I am pretty sure I was hysterically laughing and screaming all at once, this can’t be happening
but another part of my brain was calmly reminding me of the times I’ve watched someone playing a doctor on TV give chest compressions and I knew I had to push as hard as I could even though his chest seems so fragile to me, a thinly wired cage, and I actually had Meredith Grey’s voice in my head, or maybe it was the 911 operator
who told me after some indeterminate time—perhaps three CPR rotations of breathe and compress, perhaps five—to run as fast I could to the front door, where I let in a police officer who raced back down the hall with me.
He and I got Kendell onto the floor, and he kept up the CPR while I felt his pulse at his wrist, felt my husband’s pulse, which was a sharp blare and then nothing, sharp blare, nothing, sharp---
And then the EMTs were there and I stood in the hall by my bedroom, completely numb but still making that hysterical sound around the words I can’t believe this is happening now, because now has felt like it has always been coming, ever since that first heart surgery, because who can trust that life can keep going, right there in my hallway I didn’t, right there I thought it had ended and I couldn’t bear being alone so I raced downstairs to wake up my sons who had slept through it all, and they stood in the hallway with me, holding my hand, one of them, and another’s hand on my shoulder and I stopped making that sound.
The EMTs had to shock him four times before they got his rhythm back and because I didn’t have my glasses on or my contacts in, I also couldn’t hear any of the sounds they made (or maybe my brain didn’t let me hear) because in my memory that time in the hall is entirely silent until one of the EMTs said OK, got it, let’s move him and then I could squeeze past into the bathroom for my glasses.
(When I could see I completely melted down into an ugly, ugly laugh because if Kendell could’ve seen our bedroom—the vacuum knocked over, the tv askew, medical paraphernalia tossed everywhere and five men in shoes on the carpet—he would’ve been so pissed and it seemed ridiculous that I would never be able to tell him that.)
The EMTs took Kendell to the hospital. The policeman waited for me for a couple of minutes, while I raced to put in my contacts and put on a bra. Ridiculous what you think about in moments like that, but was I was thinking of was the night before my dad died, when the hospice nurse came to give him a sponge bath and change his clothes, and he dressed my dad in my mom’s t-shirt but I made the nurse go back and put on one of his t-shirts, because I knew my dad was dying and I didn’t want him to die in a woman’s t-shirt.
I didn’t want to go to the ER and be told my husband was dead without a bra on.
They didn’t tell me he was dead.
They took him into the same ER room where his mom died. They did medical things while I stood in the hall outside, while I sat in a chair, while some of the EMTs talked to me. I paced, I sat, I knew I had to call someone, a nurse stopped and brought me some water and asked if she could call someone for me, so I picked up my phone. I didn’t want to call or tell anyone because saying it out loud would make it real, because what even was this “it” that I needed to say out loud? I still didn’t know what was wrong. But I called his sister and she didn’t answer—it was 6:15 by now—and then I called my sister who answered by saying “what’s wrong?” and I don’t even know what I told her, but she came.
There are so many stories I could tell about those hours. The waiting. The way I flashed between calm and hysterical. The first conversation with the ICU doctor, who used terms like “possible anoxic brain injury” and “medically induced coma” and “base reflexes not responding well.” Conversations about what “DNR” really means. The moment I went back home to find our will, where our advanced directives are, and I couldn’t find it and I thought I’ll just ask Kendell, he’ll know exactly where it is and then there was a little bit more of that ugly hysterical sound.
There are so many stories and ways I could tell it, but reliving it will take time for me. Writing all of it down.
In the end, this is what happened: for unknown reasons (low potassium, slow heart rate, scar tissue build-up, congenital deformation in the sinoatrial node) Kendell’s heart went into cardiac arrest. He went into ventricular fibrillation but his breathing woke me up. The immediate CPR, the fast response of the policeman and the EMTs (they were at our house two minutes after they left the fire station), and, quite possibly, simple, inexplicable luck saved him. He was in a coma for two days, most of that while undergoing a cooling protocol to hopefully preserve his brain function. The doctor kept telling me bad news, that this and this and this were bad signs, and is it strange I am grateful he never gave me any false hope? But when they turned down the drugs and started waking Kendell up, he immediately responded. He woke up and he couldn’t breathe around the tube so he gestured until I figured out that he wanted a pen and he wrote (after a few attempts) I can’t breathe and then there was a different kind of hysterical sound.
Here is the terrifying thing: every nurse, doctor, EMT, and medical person we spoke with told us that most people don’t survive. One EMT said that Kendell was the reason he became an EMT, because 99% of people don’t survive, but Kendell did. Not only did he survive—he is OK. His short-term memory is a little fuzzy, but hopefully that will clear up with time. So, once we left the hospital—he had to get an internal defibrillator—I started looking.
And the statistics are dismal.
The highest one I found was 20%--meaning, 20% of people with cardiac arrest and v-fib live. (Eighty percent die.)
Another study said 5%.
Another one found that 1.79% of people with cardiac arrest and v-fib survive without any noticeable anoxic brain injury.
All of those numbers—they are terrifying. They make me look back on the entire experience and feel unable to understand why my husband is still alive, why he’s at work today and tomorrow he’ll go with me to Kaleb’s soccer game and he’ll be around for Mother’s Day.
It makes absolutely no sense that he is alive and normal. (Or, as I keep teasing him, as normal as he’s ever been.) I don’t understand it. He doesn’t understand it. But the fact is—the miracle is: he lived. He’s OK.
What is left is just filtering: trying to understand what happened, trying to let it change us in positive ways. I’ve learned that when something medical happens to someone in a family it happens, to some degree, to everyone in the family. I didn’t have to go through what he did, but it was fairly traumatic for me, too. (Ask me if I’ve slept well in the month since it happened. If I haven’t woken up panicked every night to make sure he’s still breathing, to make sure that I’m also still breathing.) My husband almost died. My husband should have died.