I went for time to a foreign land,
They fed and healed me and took my hand,
Doctors and scholars and flower bringers,
Green wood walkers and late night singers.
I hear thumps, rolling of wheels, staccato voices with the cheery upswing tones that Germans use when a bad situation must have the best face put on it–standard talk in the Intensive Care Unit. “Oh ja, Frau Hellsky, you will soon feel much better.” The nurses and technicians move as in a drill, fast but unalarmed, hooking up the new patient beside me to machines–a stroke victim it turns out. I’m hooked up to some half a dozen myself, one by suction cups on my chest, for heart rate I guess.
Traveling with my husband and teenaged youngest daughter, I’ve come to Germany this January week with the remnants it seemed of some odd secondary infection or immune reaction after a bad flu. I had low-grade fever, strange joint pains, severe muscle weakness, shortness of breath. (“You can make the trip,” the rheumatologist said, “Just take your prednisone steroid for a few weeks. Taper it down till the symptoms are gone.”)
Now it’s 3 a.m. on a Saturday in the town where we’ve come for six months of library research. As I’ll later learn, my temperature is about 41C. (almost 105 F.), my blood pressure 63 over something, my breath short, and fingers tingling. One machine takes my blood pressure every ten minutes, beeping loudly if the top number goes below 65–then someone hurries over and gives me a shot. I ask what I’m getting, but don’t understand the word for it. They’re treating me as a heart attack case. After a couple of hours they decide I’m stable and let me lie there propped, with aspirin and a bottle of mineral water, watching various accident and stroke victims get wheeled by, in the corridor. The roads are icy.
By Sunday at 8:30 a.m. things are blessedly slow. The townspeople are sleeping. The head doctor of I.C. comes and tells me I’ve been determined, from blood tests, to have a serious bacterial infection, and that Monday morning I’ll undergo procedures for heart wall testing. I’ll have an ultrasound scan, then swallow a plastic tube with a sensor, so my heart can be viewed in action from directly behind it.
“What!?” I say, “What!?” None of this relates in any way to my diagnosis in California, backed up there by numerous blood tests. At this point I look down the corridor, through the glass window that lets the nurses watch me. Something is happening, like a mild version of “the wave” at an Atlanta Braves baseball game: people are stepping to the side and slightly bowing a greeting. A presence is approaching—der Chef, the Boss.
Incredibly, on a Sunday morning in this teaching hospital, the Professor Doctor from a nearby medical university medical school, who directs this branch of the hospital, is making rounds. These Visite are highly organized. The doctor doesn’t go alone but with an entourage of nurse, technician, and possibly extra doctor in tow. They pull files from a cart as needed, and write down care directions as the doctor talks to each patient.
The great man comes to my turn, introduces himself very politely, and says he’s studied my file and determined what I need. He reiterates the planned testing. Somehow because of my steroid high, and sheer alarm, every bit of German I ever knew is in my head and working. I say that by no means will I consent to any such measures, contrary in every way to the medical advice I’ve left home with, unless I’m convinced of the reasons for them.
A kind of startle goes around the room, but the Professor Doctor smiles and calmly asks me to narrate my two month illness. I tell him of the flu, seeming recovery, migratory joint pains, fevers, muscle fatigue, the many blood tests ruling out numerous bacterial illnesses from lyme disease to Rocky Mountain fever, and my bad reaction to an antibiotic/ methoxysulfate combination drug I was given.
“Oh,” he says, “we don’t teach any use of that in our medical schools, I don’t know why they still do overseas.” He pats my arm sympathetically.
A sabbath calm has settled over the I.C. unit. Now the Chef regales us all—me, stroke patient, and entourage–with an eloquent, ten-minute disquisition, in clear lay-person’s German, on cardiovascular functioning, and blood test distinctions between bacterial and viral agents. What can I say?
The next morning, after sweating down three more fever spurts, I’m taken to the heart scan specialist. As she runs a sensor around my chest, a smoky image of my beating heart appears on her screen. She goes around it sector by sector, picking a slice, cutting it from the image, flipping it up sideways and enlarging it to show the heart wall tissues. If I had more fat and larger breasts, this wouldn’t work so well because she’d have fewer angles on the heart. As it is, she gets enough good images that I’m spared of the tube swallowing procedure that was to come next. Now I know, the only true way to be ‘well endowed’ is with small breasts! Lucky I could offer such abundant bare rib space for the sensor.
After several days in the hospital and many tests, showing no heart trouble after all and no infections, my symptoms are much better and I’m released, still on prednisone. Tentative diagnosis: rheumatic fever, now treated with antibiotics. My husband and I think over whether to give up the sabbatical and head home (tenants are in the two houses of our commuter life, in California and Washington–what to do about them?). Maybe the illness wasn’t so serious, after all. Actually I don’t believe the rheumatic fever idea. Probably the exhausting packing and traveling made the infection after the flu temporarily worse.
The less steroid I take, the more the symptoms return. Fevers, shifting pains in odd body parts, constant severe fatigue. Now the pains are in the right lower abdomen. I get checked by two surgeons worried about appendicitis, and finally the gynecologic surgeon at the hospital. He looks at my ovaries on his ultra-sound and schedules exploratory surgery immediately. This must be the infection, he thinks–aha! abcessed ovaries.
He goes over the consent form with me–risks of bleeding, death from anaesthesia, and oh, he might accidentally cut a tube from a kidney to my urinary tract–that happened to him once, he says, in his sonorous, kindly bass voice. “Aber ich könnte es wieder zusammennähen”–But I could sew it back together. It occurs to me that no doctor in the U.S. would say this. I sign the paper.
The day after surgery, still drugged, I come awake to find him standing with my husband and youngest daughter at the bed’s end. I look up from a circle of light to their craggy, partly lit faces. The pathology report came back faxed, he says. The ovaries were not abcessed–there’s no infection. They were cancerous. “Aber Sie haben Glück im Unglück gehabt”—but you’ve had good luck in bad luck, being so sick with this other thing. Because there was no tumor growth showing. The cancer’s been found early. It had come to the surface of the ovaries only at one point, on the right tube.
My mind balks totally. He’s made this up, I think. He’s lopped out my organs and there was no infection, and now he’s thought up this excuse. My husband’s and daughter’s faces are blank, mouths slightly open. They’re not succeeding any better at believing it. Em’s German is just up to slight conversation. But as I soon learn, she’s understood him perfectly.
My abdomen is bound in a corset. A catheter removes blood through my vagina, another one urine. Turns out the hysterectomy was excellently done; in a week my belly is well on the way to healed. But the nightly chills, high fevers, strange tingles, pains and bizarre blood protein readings continue. An internist takes over my case, a professor from the closest university medical school, who practices in this teaching hospital. They begin dozens and dozens of tests. Chemotherapy should start quickly, but it can’t be risked if I have Rocky Mountain fever, or malaria, etc. etc. The wipeout of white blood cells would leave me defenseless. Meanwhile I get pneumonia in the left lung, beside one of the usual pain spots in my torso. I remember the night before the surgery when I was bathed in cold cloths to bring the fever down, and the window was opened, letting in a rush of winter air onto my left side–just that spot.
Inside giant machines, having needles or tubes put in me, swallowing a liter of phosporescent dye in fifteen minutes, or having capillary blood drawn by mashing of my earlobes, I get a habit of praying the Memorare for relaxation. “Remember O most gracious virgin Mary, that never was it known that anyone who fled to your protection, implored your help, or sought your intercession was left unaided. Inspired by this confidence, I fly unto you, O virgin of virgins, my mother.” Every night I wake up shivering until, in forty minutes or so, the chills flip into sweats lasting a couple of hours.
In a mid-sized town in deepest protestant Saxony, with Martin Luther’s city down the road, there’s yet a popish church–two in fact, but only one priest. The overworked man comes to see me, a handsome blond fellow who seems younger than he is, as I soon notice. I tell him about my Marian prayers. He says, “Wer an die Mutter Gottes ruft hat eine mächtige Fürsprecherin!”–Whoever calls on the mother of God has a powerful advocate [female]! It’s said with bright eyes, with more conviction than anything I heard from him in his sweet, by-the-book homilies, the two times I got to church last month. Why does he cultivate that manner in liturgies? It’s not that he’s effeminate, which would be fine. It’s some good-little-boy persona—he needs it for protection from many things, I guess. Anyway he’s happy about the Memorare–prays it in Latin. The short-tempered doctor on call interrupts us for rounds, and the Pater leaves with both of us making a hasty sign of the cross. I’m glad he came.
Cards arrive from friends, why don’t I pack up and come home, call top doctors, organize treatment, get myself to a major clinic. I look at the oxygen tube to my nose, my I.V., my bony body, my nausea cup, my soy-based Astronautenkost. I should have gone home last month. Now there’s nothing for it but to trust these doctors. The cards and letters are a lifeline anyhow.
One evening I’m breathing badly. Our local good friend Fritzie appears with blue corn-flowers and candy-covered almonds. A doctor’s wife–teacher and affirmative action officer for the education ministry–she sees that I’m low and asks can she do anything. I’m thirsty but my hands are shaking. I ask her to feed me the cup of yoghurt on the nightstand. She hasn’t fed anyone since her kids were little. But she does it.
I start telling her what I’d wanted to tell my husband that day but didn’t because other visitors were here and it seemed too awkward. We’ve never planned for these things. If I don’t make it, I say, I want to be cremated and the ashes buried in Davis (where he teaches, and near where our grown daughters live). Fritzie starts to cry. Don’t, I say. You have to get this, then I’ll feel better. She pulls herself together. Yes. And the third thing is, I want Sister Mary Pat to give the homily at my funeral mass.
This is the co-director of the Newman Center in our California town, now being fired after several years of vibrant work and rapport with the community, for no reason but that she’s female. It’s even admitted to be so. The new bishop wants only a priest, only a man, to run Newman. The co-directorship structure is being abolished. But surely he wouldn’t nix a dying person’s request, I think. I picture Sister MP reading the gospel before her homily, as she used to. Right away I feel better. Fritzie promises she has the things in mind. I fall asleep.
Through nights of high fever and days of watching nurses at their routines, the high-dose prednisone steroid keeps me hyper-stimulated and awake, but I’m not well enough to read. My mind races. I search my memory for resources, and am glad for whatever I find–poems to say over mentally, scripture passages, prayers like the Hail, Holy Queen and the Anima Christi. . . . Good Jesus hear me, within your wounds hide me. Shakespeare sonnets, “A Dust of Snow” by Robert Frost. The vision from Isaiah 6: In the year that King Uzziah died I saw the Lord, sitting on a throne, high and lifted up, and his train filled the temple. I get to the part about the seraphim, each with six wings, two covering his face, two his feet and two in use for flying–which makes me chuckle. Then the part about the burning coal touching one’s lips. That’s a propos.
Often I think of the spiritual meditations I wrote last year. I had thought they could be published but see no chance of that now. I think of the sense of hope for a future that I found in the redness of an early sunset, in the first meditation. I picture the typescript back home in a green folder in the home file drawer where I stuck it, mixed in with old notes overdue to be tossed out, from projects long since published. Probably the kids will dump the whole business some time. What clutter I’ve left them.
Whenever I hit that image in my mental circles, it coheres with something else that keeps working me over. I don’t get the layout of this hospital. The nurses sometimes roust me up and walk me along corridors. But how the different wings are situated I can’t figure. Through the window I see that my room is at a corner where two wings converge. But I can’t picture how many wings there are, or how they go off from each other. I look out over new grass, past hedges and small trees with green leaves just budding. The spring is early this year. There’s a spot on a sidewalk where a white bus often goes by. If I could once get out, and stand with the people waiting, and look from there, I could grasp the layout.
Early one morning a male ring-necked pheasant outside makes his out-and-in breathy double honk of a mating call, just as they do on my hillside in eastern Washington in spring. I think I must have dreamed it, and shuffle to the window, rolling my i.v. mount. But no, there he is really, near the bus stop. It’s the only time I’ve ever heard a pheasant in Germany, though I’ve seen them a couple of times.
A post card of the Oregon Aquarium comes from a friend in Portland, showing lavender-lit, translucent jelly fish floating like half-bubbles, with lacy long white tentacles dangling. She says they remind her how fragile meaning and beauty are. I write her back on a card that if I get home, I’ll definitely go to see them with her. It’s a promise to hold on to.
A lay reader of the local parish, a retired math teacher Frau Schmidt, brings me communion on Sundays, not neglecting to tell me all about the theme of the week, and the special decoration made by the fifth graders, and what the homily said. She’s very warm and happy about her visitation work, though a little defensive–keen to say that she’s not one of these innovator women. She likes the church to be traditional–she adds in one of her prayers that women should be faithful to the church. I shut my eyes tight and pray it too. In a little different sense from hers.
The Protestant chaplain also stops by a couple of times and reads psalms with me, a great boon. He’s assigned to the closest red brick village church across the fields from here, with hospital chaplaincy as half his job. He did his doctoral dissertation on ‘the aggressiveness and fierceness of the Psalms.’ We trade favorite images from them.
On Friday evenings there’s a short prayer service down in a conference room–it alternates weeks, Protestant-Catholic. Patients well enough can go down in housecoats, others can tune it in on their bed-table radio if they like. One night the Pater has, at the last minute, asked Frau Schmidt to say it for him–he’s too impossibly busy. She stops by my room beforehand and tells me she’s nervous, has never done it before. My roommate and I tell her she’ll be great, and get her to explain what she’s planning. She goes down to the conference room. We turn on the radio channel. Flustered, she begins in a surprised voice, “Eine Frau spricht zu Ihnen!”–’A woman is speaking to you– [long pause] this is new!’ The roommate and I laugh and enjoy it.
Yes, now I have a roommate. The doctors are confident of their diagnosis of me as non-contagious, though they can’t get more specific than just “vasculitis,” a sort of umbrella term: swelling and constricting of blood vessels from an immune-system disorder of some kind—certain forms of it can be fatal. (Much later I’ll hear a speculated diagnosis of “tumor necrosis factor”–a protein produced by white blood cells, that normally tries to attack cancer at the tumor site by hindering its blood supply, but that perhaps travels through my circulatory system, causing indeed a very unusual form of vasculitis.)
My pneumonia has cleared. They put me on high prednisone for a week, and order the nurses to get as much food in me as possible, plus vibrating my back every day to clear the lungs. I’m to get strong for chemotherapy.
I start thinking of a poem. Especially when I have fever, the phrases and lines come to me. As I piece each section together mentally, I go over it a few times to fix it in memory. It’s about the biblical Job, spoken by his daughter Jemimah–one of the bevy of new kids he gets after his ‘fortunes’ are restored. Maybe soon I’ll feel like writing and get some of this down. Last week I worked up one in my mind about the gospel story of the ‘city woman.’
My roommate was depressed when we were first put together. She’s had her third heart attack and must move into a care facility. The first night she told me she’s picturing her grave all the time–the hole in the ground, the open coffin, the cement slab. Can’t get it out of her mind. This is strange talk. North Germans are usually very reserved and formal, even with friends long known, all the more with strangers. Maybe as a foreigner, speaking a little ungrammatically, I seem outside the social categories–kind of a freebee listener.
I think of her grave and my own wish to be cremated. But I pluck up rationality, and say that it might be good to think about dying and try to get ready, but I don’t see why we should think of the grave in particular, because once our body’s in there, we won’t know anything about it anyhow.
She asks how I think of death.
I say I think of the sense of God within me, that I have when I pray, and that either whatever there is of me will be united with that God, or else there’ll be just nothing. And either way, there’ll be no sorrow nor loss nor trouble any more, so I don’t think there’s anything to be afraid of. She turns off her light.
The next day she starts telling me about her life and her children, her tennis playing and her garden–a Tennistante she was, always hopping on her bike and heading for the courts when a little sun came through the clouds. Each dinner time we drag ourselves up, sit at the little table in our room with a vase of flowers, turn on the lamp, and make ourselves gemütlich (a word for, all at once, cozy, friendly, cheery, and well-arranged).