Dying in Three Acts II

Act II

Prelude

For my 24th birthday I gifted myself a month at Great Vow Zen Monastery in Oregon. Remote and quiet, the monastery – a refurbished middle-school – sits in a clearing among verdant forests. Little did I know that my birthday fell during the week of Parinirvana Day, a time when Mahayana Buddhists reflect on impermanence and death. For Great Vow, a Soto/Rinzai Zen monastic community, like other Mahayana Buddhists, this deals with the death of the Buddha, and impermanence in general. In complete silence, avoiding eye contact, reading, or anything that might activate the “discursive mind,” the intensity of that week-long Parinirvana sesshin (meaning “touching heart-mind”) stuck with me. We envisioned dying on the cushion during meditation; watching how others might react to our drooping, falling ‘flesh sack of bones;’ we contemplated graveyards, and even dissected a dog that had been hit by a car on the nearby road. Jan Chozen Bays, my teacher, had been a practicing doctor for years. The monks placed the dog’s body near one of the many large doors. We gathered around to watch her execute the autopsy. Chozen cut into the dog’s chest, exposing various organs. The smell was terrible. Further cutting into the bones of the rib-cage, she said, “And there it is, the bleeding.” We could see that a lot of blood had coagulated from a blunt-force trauma in the dog’s lungs. The autopsy complete, several monks took the dog, nailed him down in a nearby place where the grass became forest. I never went out there, but I was told that monks would go reflect on its decomposition. (Oddly, in keeping with my early 20s theme, for my 23rd birthday I went to Death Valley, and earlier I had feared that I would die just before my 21st birthday.)

. . .

As I lay dying, my two phones began to run out of battery. The first person I had called, as I noted in Act I, my father, asked for my maternal grandfather’s phone number. Despite having no contact with me for three-decades he assumed it was his right and duty to reconnect me with family. A better man would have asked for my consent, but he, debased by racism and chauvinism, cared not for understanding or asking. I reluctantly gave him my maternal grandmother’s number. They had a grand old time. Tony, my Sicilian father, felt vindicated that my grandmother thought of him in a positive light, and he had the opportunity to speak to his ex- and first wife, my mother, and seemed almost jolly. A grand reunion, decades in the making! I realized that when you are dying, people go insane. He demanded I call my mother. They let themselves go. Out of sheer nervousness of their own mortality combined with the excitement of something happening in their worlds of sheer banality, they begin to call up people, or – as one person did – become incredibly angry with me.

Hauled via ambulance, this time securely wedged in sheets and carefully transported on a gurney, from the room where I received a blood transfusion and into another intensive care unit. I met with another doctor. He refused to speak to my husband, Alexander Verney-Elliott, saying it was against the law. He did give my father, whom I haven’t seen in thirty years, all my information. The doctor handed my one remaining phone back to me, in a room that looked like a large janitor’s closet; Tony said that according to his conversation with the doctor my situation was critical. I felt myself start to cry. I would later explain to his friend, a US-American, that I was tired of the homophobia. Tony ignoring Alex. Tony putting me on speakerphone with my grandmother: where she asked – ‘Are you dying from AIDS?’ Here I was: not only physically dying, facing very real, and now probable, imminent death – alongside a social erasure. Straights talking over my corpse. Tony even asked my abusive grandfather (!) where he wanted my remains to go! After I said that I wanted Alex to take them to Loch Ness.

I organized myself the best I could. Alex, my nonsexual, life-partner and legal husband, does not have a mobile phone. He’d also recently changed his number. After several emails, we managed to connect on the phone that wasn’t dead. I, as usual, candidly told him told the situation. A doctor from Nigeria, sympathetic to my situation, spoke loudly so that my partner could hear the situation on the phone – bypassing the homophobic doctor (Italian civil partnerships are legally recognized) – and this is where I first heard – where there is 2.4, there is no life. I said: Alex, come now. He didn’t have the cash to come, but managed to scrape it together and get on a night flight via Rome to Palermo. Returning to my room, I called him again; I wanted him to be the last person I talked to. I turned off the phone. For several more hours during that long day, doctors entered and left; time blurred into a perpetual now; the death rattle pulsations at the back of my neck stopped. Bags of blood kept coming. And I was starting to feel quite nauseous and hot, a typical symptom of blood transfusions. My vision, by now so bad, made it so taking off or putting on my glasses had no effect. I guess I’ll need a new prescription, if I live.

Several times I nearly fell into the aperture of nothing/ness. The nurse, an amazing young woman, attended to me with great care. I explained my vision, the dizziness, the confusion, and she, holding my legs up, shouted, “Aspetti! Aspetti! Aspetti!” After a few moments she put my legs down, came over to head and put her face above mine. I could see her eyes, like those of an Angel, above her mask. I was sweating profusely. My oxygen absorption percentage kept registering low. In a moment I will never forget, during the COVID19 crisis, she popped off my masked and shouted “Respiro!” I felt the cool air coming in through the window. Some sweat from my face made a droplet and flew into the air as she removed my N95 mask. As she left, she repeated, using her hand to make circles, respiro! respiro! respiro! Or, breath! breath! breath!

After a lengthy wait, I was taken to Internal Medicine, two floors up. Hot, disoriented, still being shoveled from death, I met an amazing cast of characters that far exceeds anything on TV. Nurses and doctors with exceptional professionalism, humor, exuding a kind of healing feeling. As my cognition faded, I forget I was in Palermo. I forgot what I had been doing for the past months, and my intuition took over. I felt if someone who entered the room was trustworthy, friendly, helpful or not. After speaking with with several amazing doctors, and by serendipity, one named Carlo (who had studied at Columbia University, we had both lived off Amsterdam Avenue: he in the 180s and I on 142nd) that understood, culturally, the situation with my family, and wrote that Alexander Verney-Elliott was my only next of kin and the only person authorized to speak about my care, per my instructions. Surprisingly, something turned on, and I began to go into the medical history my maternal family’s problems with rectal issues, colon cancer, etc. I managed to flip a switch, explaining my medical history in great detail, each medication I was on, the dosages, the effects, the possible diagnoses, etc. After this my thoughts returned to semi-coherent mush, and I collapsed into a state of exhaustion without sleep.

Blood party, or Festival del sangue

Getting blood delivered in a timely fashion became a challenge for the hospital; my blood type, being so rare, required the hospital to order it from all over the island. But the blood came. And came. And came. As the day turned to Friday night, a party roared outside, amplified by the mountains that surround the city. I thought we were near the beach, and it sounded like a beach party, but we were not near the beach, although I think it was a very loud beach party, echoing. Dogs howled. Cats meowed. Doctors and nurses came, regularly, in waves, in groups of five or six; I could tell I was sitting on a/n l/edge. Carlo gave me a phone charger. I couldn’t unlock the SIM, but a very helpful gentleman, a man who worked for Palermo’s mayor’s office of culture and who happened to be my roommate, allowed me to call my out-of-country network provider and unlock the device. I called Alex. Hearing the phone ring and ring, I knew he was on his way. I played everything from the classical music selection on Spotify. I recorded my Last Will And Testament onto my phone; my roommate and a very quirky, sweet young man from Frankfurt – from the room across the hallway – left to give me space (and sneak a cigarette break). The night had arrived.

I was washed in my bed by John and another nurse. I had never had a bed-bath. As I could barely move, this was required. A shoe that I had lost earlier in the day during transport was found, and I thought this perhaps a good sign. Maybe I will walk out of here. Carefully, they held my arms up and elevated my legs on a plastic absorption mat. Making a U-shape, my body, scrubbed by these two amazing individuals, felt slightly refreshed and dignified. The indignity, which I would later embrace as a sign that we are all fragile, vulnerable and susceptible to anything, came when I had an adult diaper placed on me. I couldn’t move to the toilet, so if I needed to poop or pee, or die, this would make it easier for their sanitation services. I wanted to put something over the diaper, but the doctor gently nudged me that it was hot and best to just have the diaper, and, through sheer duration, I relented. Soon thinking how it didn’t matter if I died in diapers, and if I lived then it didn’t matter either. Satie and Penderecki played on — especially Three Pieces in Baroque Style, by the latter. I played this on repeat. More and more blood came, blood tests were ordered, and other IV’s were needed, John continued to find veins on both arms to accommodate these in-and-out needles. After one such injection, I recall saying, “Thank you, John,” and thinking this a good title for a book about dying. He timed the drip of the blood from the bag in order to calculate exactly when the next bag would be needed. He tirelessly worked on finding new veins, a process that took longer and longer as the night went on. He saved my life.

Young doctors had the night shift. Two brilliant women, one from Sicily and one from Milan, the Milanese doctor spoke excellent English. They called the night a Blood party, or Festival del sangue. This cheered me up as I could hear the revilers outside. The night of the Festival del sangue, sundown 21 August to sunrise 22 August. Perhaps I will make it a holiday considering its profound effect on my life. Death alters life. Meditating on death is not the same as experiencing its scythe nearing your vulnerable body. I thought of the victims of war. I rethought my fears of bodies, of my own body, my own fragility, and my own mortality; my fear dissipated; I could look at the most horrendous image in my mind objectively, calmly as an art. Having had intrusive thoughts of genital self-mutilation circa my 12th year around the sun, this new view surprised me. A curse had been lifted. The hallucinations intensified as the night progressed and my temperature increased. A cortisone shot helped reduce my fever. I saw a cowboy in the room, then a man holding an old camera, as though Ansel Adams himself were photographing me from the IV stand. Red blood cells and smoke filled the hallway and black strings cascaded from the ceiling and upwards from the floor. Up and down. In and out. Blood. I kept seeing blood. Closing my eyes, I went deeper into my fears: I saw naked bodies, rolls of skin, pubic hairs, bodies congealing with bodies, flesh touching flesh, almost infinite amounts flesh intermingling and merging with other flesh, folding like origami. Orgasmic, cosmic, the bed felt like it moved forward or backwards when I closed my eyes. I descended into a dusky, dive bar. Jimi Hendrix stood there, almost frozen, smiling. His face grew until it became the wall. Multicolored neon broccoli covered the entrance and exit of this bar. Other parts of this experience included the contraction, a literal squeezing, as one does with dirty sponge, of first my 15 years. I will take the last 18 years – but I can’t recall more than a two dozen memories between 0 and 15, so I let that time period twist and shrivel (the constant nightmares about my mother have ended since this experience). Oddly my mother, being contracted, squeezed from my past-present, kept calling me throughout that night. So did one of my siblings. I didn’t answer. The curse has been broken.

The music played on. The dogs howled. Blood flowed. My flesh began to feel alive again. I could smell myself (I hadn’t realized most of I had lost taste and smell). The smell of urine on my shirt from peeing in the Papa Gallo. The sweat. I could see why my roommate had complained of the smell.

Waves, a dance of doctors and nurses, came in and out; a theater of the sea. At one point I felt a warm pressure on the left side of my back. I explained to the Milanese doctor that I thought I had sprung an internal leak! She examined my back and could hear my lungs clearly. No liquid. That’s the sound of your heart beating. You’re alive. I hadn’t felt my heart warm and beating properly for weeks. Normal rhythm felt alien. I asked her if this is what it felt like to come back from the dead. She brilliantly answered, putting her palms up and saying, “I wouldn’t want to speculate.” Truly, I needed a physician, not a metaphysician. We laughed. That night involved a great deal of laughter. The next day, an incredible and zany nurse, a beautiful, voluptuous woman with thick, red-and-black died hair I had met when I first was moved to Internal Medicine, came in and did a disco move: putting her finger in the air and sliding across my room. She sang, “Ay, Ay, Ay, Tony is Stayin’ Alive, Stayin’ Alive.” I laughed deep at this gallows humor. By late that morning, I had finally fallen asleep – after more than 40 hours – and woke in a cold sweat. I knew Alex had arrived, for I felt his presence. I slept like il gatto che sono. The cat I that am.

End of Act II

This short piece is dedicated to Alexander Verney-Elliott, my anonymous blood donors, the nurses, doctors, surgeons and other staff at the University Hospital Policlinico Paolo Giaccone, and especially those in Internal Medicine and Emergency Surgery. They saved my life.

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Ingmar Bergman’s The Seventh Seal (1957) A pensive knight, Antonius Block (Max von Sydow), plays chess with Death (Bengt Ekerot)

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