A Season in Hell (21 page)

She had broken my back.

*
Primo Levi,
Survival in Auschwitz: The New Assault on Humanity
(1958), trans. Stuart Woolf (New York: Collier, 1961), 106–7.

T
HE MASSEUSE WAS SO
frightened by my terrible scream that she would not leave until a doctor examined me. I called Edie Langner, my internist, whom I had not seen for a year, and she persuaded her then partner, Lucy Painter, to come to my apartment. But back problems are invisible. By the time Dr. Painter arrived, I was merely in pain. She believed I was in spasm and told me to rest for a few days.

The next day, the pain was unendurable; in my experience, the pain does not become severe until the day after a break. All my friends agreed that back pain was “the worst.” I could not move without weeping—getting out of or into bed was truly awful—but I assumed this was what back spasms felt like. I remained in bed for three days; on the fourth day, I pulled myself out. I went downstairs, piled my desk chair with pillows, and returned to work.

Reviewing my calendar for this period, I am startled to see how I drove myself despite my broken back. I sat at my computer, revising the history book. That I lost only three days of work seems inconceivable to me now, remembering the agony I was in. My calendar claims I went to the theater, took my father to an ophthalmologist, made dinner for him, accompanied him to the hospital for a cataract operation, made dinner a second night because he had to see the doctor again the next morning, having developed a minor problem in surgery. I remember doing these things. I do not remember how I felt. I also saw real estate agents, because I planned to sell my apartment.

My call to Dr. Langner aroused her concern, and she called and asked to see me. I went in on October 12, almost two weeks after my back was broken, and told her how much pain I was in. Edie asked for details about my illness: I had not seen her since the cancer was first diagnosed. There was no easy way to do so; I was being treated elsewhere and had no reason to consult her. It never occurred to me to keep her aware of my situation, for her to oversee it. The specialists would not defer to her, I knew. And I did not want to present myself to her during my cancer treatments: her husband—who was treated at least partly at Sloan-Kettering—had died shortly before my diagnosis, and I did not want to be a reminder. I knew she was heartbroken.

But now I laid my problems out before her with huge relief. Eager to know all the details, she never once made me feel rushed, never once acted inattentive. This was the answer! She
wanted
to oversee my whole self, medically, something I had longed for. She sent me to a back specialist, who told me to wear a brace and prescribed Dilaudid. The pain pills helped if I took them continually, but that I did only for a while.

Meantime, my throat had closed up again, and I made an appointment for another endoscopy. I knew, though, that there was someone looking out for me, someone I could call without embarrassment or anxiety that my call would not be returned, as sometimes happened with my oncologist.

Over the weekend, I went to the movies and lunch with Herb Weiss and had lunch the next day with Carol and Esther. Monday morning, I entered S-K for the operation. Rob accompanied me; then we went back to my house and ordered dinner (probably from Rainbow Chicken). Charlotte had invited me to visit the following weekend, and since her country house was closer than mine, I thought I could manage the drive. But I was only about three-quarters of the way when I doubled over with pain. I don’t know how I made it; I drove in a twisted position, then lay in agony on Charlotte’s couch for the rest of the weekend. Charlotte and her friend Miranda took me home, one of them driving my car, the other, her own.

Edie Langner had suggested physiotherapy for my back and sent me to a dance therapist in the Ansonia building. When I saw her Monday morning, she gave me a treatment and told me to obtain a back brace. I finally bought one, wearing it that evening to the Met. Earlier that season, I had ordered various opera tickets, trying to make up for the wonders I had missed during the past two years. Two productions were scheduled for that week—
Stiffelio
at the Met and
Madama Butterfly
(the original version, which I had never seen) at the City Opera.

The next day, I went to my oncologist. He took my back pain seriously, because after being eliminated elsewhere, cancers frequently invade the bones, especially the spine. I had a bone scan that afternoon. When he called to tell me the results, he said, “I’m sorry to tell you … ,” and my heart stopped. But he continued, “… that you do have a compression fracture.” He had sandbagged me again. So it was not until the end of October that I finally realized my back had broken, that the pain was not from spasm, and that there had been good reason for me to weep. He told me that the radiation had probably harmed my spine (although of course I had not had enough to make this happen). It was sawdust; I had severe osteoporosis and could have another compression fracture easily. I had to be careful.

Wearing the brace, and down to two pain pills a day—in the morning and at night—I had dinner with my publisher, Jim, attended a reading of a brilliant new play by Janet Neipris, and went to the movies and dinner with Gloria. But my next session of physiotherapy put me into agony again. I stopped treatments. But I continued my social life. The calendar for the following weeks reads as if I gritted my teeth, determined to have my old life back no matter what: there were parties or dinners almost every night, an evening at a cabaret starring Donna McKechnie, and a long afternoon spent participating in a conversation about pornography and censorship that would be printed in
Ms.
magazine. During the day, I worked on the history book revision, had back X-rays and an MRI, met real estate agents.

By November, the pain had moderated a bit, but it was always present, its dull ache reminding me not to move too quickly or in certain ways. I wore the brace every day, although I questioned whether it helped. I now took the Dilaudid only once a day. I could not stand up straight long enough to prepare a meal, so I hired some young men to come and cook for me on the evenings when I was home. Charlotte recommended an osteopath with a tremendous reputation and self-esteem to match. But his superexpensive treatments did not help at all.

On November 20, my dear friend Beatrix Campbell traveled from England to spend my birthday with me. Unable to come while I was sick, she made a surprise visit now. We talked for hours, our conversations always among the most brilliant and lively of any I have. Our subject is usually politics, her specialty, but we go far afield. The kids had arranged a dinner party at the Café des Artistes, one of my favorite restaurants (it serves pot-au-feu, a rarity in America). Then I dragged Bea shopping: I had to get birthday gifts for Rob and Jamie. If she did not enjoy that, she made the best of it. Bea and I went to the Met to hear
Russalka
, and one of the cooks prepared a lovely dinner at my house for Bea, Ann Jones, and me.

Bea was soon gone, but my social calendar was filled in to the end of the year. I had tickets for
Les Troyens
,
Angels in America
, and
All in the Timing
; there were parties at Lisa Alther’s and at Alix Kates Shulman’s, a coven meeting, a Christmas Eve party, a dinner with Gloria and Carol. But first was a dinner with Charlotte, at an old French restaurant on the West Side. We had finished eating, when I almost doubled over with a pain in my side. Perhaps it was gas—had I let myself go too long without eating? That always caused problems for me. Perhaps it was the brace, which was extremely tight, confining my lower back and waist. I told Charlotte I had to go home. On arriving, I removed the brace, but the pain persisted. I put myself to bed and lay there, feeling awful. During the night, I began to shiver; my teeth chattered, and I could not get warm.

This continued into the morning, when it occurred to me I might have a fever and that it might be wise to call Edie—I might be coming down with flu. When Edie heard my symptoms, her voice rose; she told me to get to the emergency room at St. Luke’s–Roosevelt
immediately
, that she and Lucy would meet me there, that I had an infection, probably in my kidney. Worried about my reaction to the hospital’s emergency room, she told me not to be upset by it; she and Lucy would meet me there and walk me through.

Dazed, I dressed and tried to pack for the hospital, but I was befuddled. Isabelle helped me. I called the kids and told them what was happening, and they said they would meet me as soon as they could. By the time I reached the ER, I was pretty sick: I have little memory of what occurred. I know the children were there; I don’t recall seeing Edie or Lucy until much later, long after I was admitted. A new doctor, a urologist recommended by Edie, Frank Lowe, examined me and said I had a kidney infection and needed what sounded to me like an operation. No operation, I said. I would not be invaded.

But I was in no condition to be making such a judgment. I was in and out of delirium, in terrible pain, my whole body shaking. The next day, or perhaps it was two days later, Frank and Edie approached me together, almost formally. They told me I would die if I did not have the procedure they recommended. It was not actually an operation, they said, but the insertion of a tube that would allow the pus to drain from my kidney, which was impeded because I had so many kidney stones. Believing I was on the verge of death, I agreed.

They rushed me into the operating room. I was given anesthesia and remember little about it except that as they were wheeling me out, Dr. Lowe turned to the doctor who had assisted him and said, “We got her just in time. Another hour and she was dead.” The second doctor concurred.

Six months later, I was a patient in the same operating room (I would be in that room often over the next years) and met one of the nurses who assisted the first time. She cried out when she saw me. Embracing me, she said she was so happy to see me, so happy I was better. She remembered me very well: “It was just before Christmas, and I had a plane reservation—I was going home for the holidays—but Dr. Lowe said I had to stay, that you were dying and needed this procedure, so I stayed, and oh, God, you were so sick, I’ll never forget it. He said afterward that we’d saved your life. I felt so proud.” Then she kissed me.

Sociobiologists who emphasize the aggressive selfishness of the human species never consider our tendency to love those for whom we make a sacrifice and the place of that love in our lives. Although I recall that nurse with affection, I don’t even know her name. I’m sure I asked it when she spoke to me, but I did not manage to retain it. She will never forget me, though, not because of anything I am or did, but because of what
she
did. What she did helped to save my life; she enriched me. But her sacrifice most of all enriched
her
; my surviving enriched her; her love for me enriched her. All this love she offers—for surely I am not the only patient to benefit from it—will probably carry her into a contented old age. I believe that is the way life works. Instead of looking for a gene for altruism, students of human behavior should consider how altruistic behavior benefits the actor, how love enriches the lover more than the beloved, how virtue truly is its own reward and aggressive behavior its own punishment.

The tube was inserted, but I remained quite sick. The infection drained slowly, for the kidney stones continued to impede it, and my fever remained high. I had the usual visitors in the hospital, but was not my usual cheerful “hospital” self. I felt aggrieved, felt that things were stacked against me. Edie and I had worked so hard to keep me well: Edie, always worried about my damaged kidneys, had checked my urine regularly for signs of a kidney infection. She had done it only
one week
before I got sick. And I scrupulously followed her instructions. What more could we do? I had just recovered from the worst of the back pain, just begun to heal. I had tried so hard to function despite it, to keep a positive attitude, to recover my old life and well-being. And here I was spending another Christmas in the hospital, all the planned holiday events forgone.

I was as low as I had been since I woke from the coma. I was sick of being sick, sick of being in hospitals, having my body invaded and stuck and drained and listened to by stranger after stranger. I can’t count the doctors who treated me or whom I consulted through my illness, because I did not see some of them, did not know many of them, and do not remember all of them. But I saw, knew, and remember about fifty different doctors. I felt like Beckett’s creature crawling through mud in
How It Is
, who continually deludes himself that he/she sees light ahead, that he/she is getting someplace. But I was even worse: I kept encountering horrors in the mud and kept trying to get past or ignore them. I did not know how much longer I could fight. I did not want to live a self-pitying life, but I was overcome with despair.

The infection was so stubborn that the doctors did not want to release me without an extra measure of protection, and urged me to have a stent inserted in my kidney. A thin plastic tube that I would not feel or see, the stent would permit drainage in the organ despite the kidney stones. I saw these during a sonogram, and they were certainly plentiful. (I do not know if I had them before I became ill; chemotherapy can cause kidney stones.) I asked the urologist if it was not possible to get rid of kidney stones; he said it was but that there were two sorts of stones, each requiring different treatment; he gave me some vague reason why that could not be done now. So I agreed to the stent, which the urologist promised would protect me against further infections. It was during the procedure to insert the stent that I met again the nurse who had earlier given up her plane ticket to save my life.

After a two-week stay in the hospital, I was very weak. A couple of years later, a nephrologist told me that for unknown reasons, hospitalization was particularly hard on kidney patients, who require a week to recover from each day in the hospital. It would take fourteen weeks, over three months, to recover from two weeks of hospitalization. But I did not know this then, and felt low and hopeless and grouchy as I stumbled around my apartment, once again weak and not in control of my movements.