The Veridian Fingertip Oximeter is a small plastic widget that monitors your blood oxygen level. You can buy one for forty dollars at Radio Shack. Anything between 95 and 100 is healthy. A reading below 90 indicates hypoxemia, an abnormally low level of oxygen that can damage organs over time. A number below 80 indicates possible suffocation of the heart and brain. I became familiar with these dark numbers two years ago when my father’s lungs began to fail and we sat at the kitchen table together, monitoring his blood in the days when he began wearing an oxygen tank. In a few days we will travel to a hospital in Wisconsin, where the Department of Veterans Affairs has approved him for the first stages of a lung transplant.
I recently spent five nights twisting on a damp mattress with a fever of a hundred-five, watching the ceiling fan spin like a chopper, imagining myself waiting for reinforcements on some godforsaken jungle isle while my memories merged with scenes of Martin Sheen in Saigon. Each day my breath grew shallower and my dreams turned rubbery and strange. Complicated dreams about whether a mental breakdown occurs gradually or slowly. This debate took place in the ruins of an old university where I was forced to played chess with pieces of tandoori meat. A loudspeaker warned me that this is “a game from which one cannot withdraw without suicide,” borrowing Alan Watts’s description of life. Yet the prospect of interacting with the American healthcare system frightened me more than any fever dream. Seeking help would result in paperwork, claim denials, and, worst of all, witnessing the most horrible kind of greed by dealing with those who profit from another’s pain. I drank more juice and waited. My fever did not break, breathing became painful, and I did not sleep for three days. When I finally surrendered, the doctor at the clinic took one look at me and responded triage-style. A dozen hands shot me with needles and stuck a plastic tube down my throat before hustling me into an ambulance. The medics strapped me to an oxygen tank, the same make and model that my father uses. Call it a Twilight Zone twist, a hard lesson in empathy for my father’s failing lungs. While the ambulance scanner squawked, I stared out the smudgy back window at the grey January interstate, wondering how I managed to catch such a severe case of pneumonia.
Pneumonia. It sounds old-fashioned like consumption, rickets, or dropsy. Pneumonia is the disease of forgotten aunts living in damp attics, of street-grate drunks and tragic poets, of grizzled men trying to prove something at sea. I am not interesting enough for this illness.
The emergency room doctors wired my arms and face with tubes, then they stored me in a small room while they discussed what to do with me. Pneumonia means unwillingly watching hours of CNN while waiting for the next needle or test result. I stared vacantly at rotating graphics of bombings, celebrities, and slaughters. The world was in crisis, filled with relentless emergencies. Illness finds each of us sooner or later, and for me, it happened on a dreary Wednesday afternoon when my oxygen levels dropped into the seventies and the doctors said my pneumonia was double-barreled, crystallized, and fluid. “Close call. If you waited another day before coming here, you’d be in serious trouble. That’s why your body wouldn’t let you sleep. Probably wouldn’t have woken up.” Several doctors seemed to enjoy pointing this out to me.
When the body rebels, the mind realizes it’s been preoccupied with the wrong things. To think I was worrying about money when I should have been celebrating the ability to take a deep breath.
In 1926 Virginia Woolf wrote an essay called On Being Ill. “Considering how common illness is, how tremendous the spiritual change that it brings, how astonishing, when the lights of health go down, the undiscovered countries that are then disclosed, what wastes and deserts of the soul a slight attack of influenza brings to light,” she wrote, “it becomes strange indeed that illness has not taken its place with love, battle, and jealousy among the prime themes of literature. Novels, one would have thought, would have been devoted to influenza; epic poems to typhoid; odes to pneumonia, lyrics to toothache.” Woolf blamed the limitations of language: “English, which can express the thoughts of Hamlet and the tragedy of Lear, has no words for the shiver and the headache. It has all grown one way. The merest schoolgirl, when she falls in love, has Shakespeare or Keats to speak her mind for her; but let a sufferer try to describe a pain in his head to a doctor and language at once runs dry.”
Perhaps illness exists beyond language or thought because it is such a frightening and visceral ordeal. Much like death, depression, and enlightenment, illness is only experienced alone. My father wanted to visit me in the hospital but I begged him to stay away. When he arrived with our chess board, I shooed him out of the room. The prospect of giving him pneumonia a week before the preliminaries for his lung transplant was more than I could stand.
A Greek word for the inflammation of the lung, Hippocrates described pneumonia as “the illness named by the ancients.” Pneumonia has been called “the captain of death” as well as “the old man’s friend” because it can deliver a swift and relatively peaceful death in place of a long and painful illness. For me, pneumonia was a preview reel, projecting grim scenes of an old age spent fighting for breath while I sat with my eyes closed on the cold linoleum floor, unable to stop coughing after an exhausting pilgrimage to the bathroom fifteen feet down the hall. The nurses urged me to use the pee container but I refused, suspicious that giving up this last shred of dignity might worsen my condition. I also rejected the hospital’s rubbery socks that prevent blood clots, nor would I trade my t-shirt and pajama pants for a floral gown. Perhaps it was the fever talking, but I became convinced that peeing while lying in bed and wearing hospital attire might lead to death.
I entered this year filled with resolve, determined to maintain a tight grip on my daily routine, to finally put my novel in the mail and see if I could make some money at writing. Instead, I ran headfirst into the mocking world of cliché: If you want to hear god laugh, tell him your plans. At least you have your health. I ruminated over unwritten pages, untaught classes, and the mounting crush of email and paperwork. I worried about the impending hospital bill and the inevitable fight with Blue Cross Blue Shield. Then I thought a terrible thing: Why me? The universe answered by slapping me across the back of my brains: Why not you? That I am writing this today means only that I am lucky, for there’s that other cliché about every breath ending one of two ways. Life is little more than the spin of some lunatic roulette wheel, the landing of the ball determined by subatomic clicks and unseen angles.
But what am I supposed to do in the hospital? With their feeble colors, ghastly lights, and dispassionate linoleum, hospitals are not designed to remind people that life is worth living. I read fiction and autobiographies and watched crime dramas but soon all plots begin to look the same, e.g. a person wants to go home and go to bed but things stand in his way. I slept for a few minutes at a stretch, suffering more dreams before my fever broke: 1) a murderer who strikes by creating traffic jams in front of ambulances; 2) being told that I contracted a rare disease and now no matter where I walk it will take one hour and seventy minutes.
Waking from a nap, a stern woman in a black pantsuit sat in a chair near my bed. “Are you awake, Mr. Reeves? I am the hospital chaplain.” She asked about the condition of my spirit. I asked if these were my last rites. She smiled. “I’m simply checking to see if I can assist with your spiritual needs.” I told her my spirit was happy, joyous, and free. She wanted details about my religion. “I read.” I ignored the rest of her questions until went away, then I wondered why I wanted her to leave so quickly, why her presence offended me. Why the idea of god scares me. I stared into the fluorescent lights and counted the tiles in the drop ceiling until sleep returned.
The hospital kept me for six days and sixty nights. On the third day, I made peace with death. I’ve watched death claim people I love and I know it’s a bland and ugly thing, but I’d nonetheless imagined my own death as a detached and magical event like an award-winning movie scene — but no, death easily could have found me alone in an antiseptic room on the third floor of an aging hospital while Wolf Blitzer droned about terror from somewhere down the hall. Illness is clarifying. Woolf again: “We cease to be soldiers in the army of the upright; we become deserters. They march to battle. We float with the sticks on the stream; helter-skelter with the dead leaves on the lawn, irresponsible and disinterested and able, perhaps for the first time for years, to look round, to look up — to look, for example, at the sky.” If my lungs fully recover, I expect I’ll lose some of this clarity, so I write this sentence again and again as a reminder: Nothing feels quite so humbling or graceful as walking out of a hospital. I am thrilled to be back in the world. It’s a grand place, even if it takes a little longer to walk through it these days.
The Veridian Fingertip Oximeter has become a small obsession. I check it while I walk around the house or climb the steps to my classroom. I’m hovering just below 90 this week and the doctors say it will take a few weeks or months before I’m back to normal.
Here is my father in the morning, after installing his hearing aids, contacts, teeth, and oxygen tank: “Now I can hear people. I can see people. I can bite people. I can breathe. I am bionically restored. Let’s go.” As we prepared for our trip to Wisconsin and into unfamiliar terrain, I realized that my father speaks the appropriate language for illness: black humor, that beautiful combination of acceptance and defiance.
