Missing the signs (2018)

Five or six hours before I will sit sweating and crying on a gurney in the emergency room, I sit clothed and composed with our primary care physician. Suzanne reads patiently in the waiting room. Our physician is a small woman with a pile of frizzy black hair and a distinct Italian accent. She is usually smiling, asking questions, and glancing only quickly at my records. Today she stares uncomfortably at the monitor, clutching the mouse and rarely turning her head. My blood tests concern her. And the hematologist isn’t calling her back. She starts to explain what she sees and why it seems serious. I don’t understand. But the tone in her voice makes it sound like something a husband and wife should hear together, so I go get Suzanne.

She doesn’t greet Suzanne. The monitor hangs on the wall, above her head. Still clutching the mouse, she cranes her neck upward and continues to talk about the results. An automated test was unable to categorize about half the cells in my blood. She checks her phone. And the hematologist still isn’t calling her back.

“His chest x-rays are clear. He doesn’t have pneumonia.” Now she does glance at Suzanne. “That isn’t why he’s having these fevers.”

Somewhere I hear the word “cancer.” Suzanne doesn’t. Maybe the doctor only said it before I went to get her. Maybe it was why I went to get her. Or maybe she does say it now, and Suzanne doesn’t hear it. But we both hear the doctor send me to the emergency room.

“Go to Beth Israel. You know where it is?”

“Yes,” Suzanne answers.

But the doctor tells her anyway. “Out to Brookline Avenue. Take a right. About half a mile. Look for signs on your right. Beth Israel Emergency Room.”

We have been coming to this same health center since 1995, when Suzanne was pregnant with our first child. It is part of the wallpaper of our lives—these halls, this elevator, the second and third floor of the parking garage. The rugs have changed over the years. So has the paint on the walls. As we walk out, both of us are thinking not about me but the kids. We each remember different medical misadventures that brought us here with one of them, usually alone. Twenty-two years of “you do this while I do that.”

“How long do you think it’s been since the two of us were here together?” I am holding open the door to the second floor of the garage.

“At the same time?” Suzanne is searching through her purse. “Oh. I don’t know. Years?”

We forgot to validate our parking ticket. I start back with her but end up waiting on a bench along the way.

We drive out of the garage in silence. She clenches the top of the wheel. Both hands. And she peers out the windshield the way the doctor was peering up at the computer monitor. We are still silent at the first light. Allowing each other to be silent is a kind of intimacy. Maybe it’s a stage of intimacy—a late stage.

“This is Brookline Avenue?” I ask at the second light. I rarely remember anything about driving in Boston.

“Yes. It goes straight through this intersection.”

“I will never understand this intersection.”

She slides her hands around both sides of the wheel and almost smiles. “I’m pretty sure nobody does.”

At the third light, I ask, “Are you going to drop me off and go home? Check on the kids and come back?”

“I should probably touch base with them.”

“I won’t see a doctor for a couple of hours. You have plenty of time.” Traffic starts moving. “She did tell us, right?” I mean the doctor. “That it isn’t pneumonia?”

“What do you mean it isn’t pneumonia? I didn’t hear that.”

“My chest x-rays were clear. Remember?”

“No.” She is clenching the top of the wheel again. “I don’t remember that at all.”

“Maybe I misunderstood.” I also want to think that it might just be pneumonia. I don’t mention cancer. I don’t mention it because, at this point, I don’t remember hearing that word.

“There it is.” Suzanne points. We are stopped behind traffic at another light, which is changing to green ahead of us.

“But that’s is a left,” I object. “She said a right.”

“This is Beth Israel. All these buildings. Where else could it be?”

“Have you ever seen an emergency room that wasn’t surrounded by enormous, unmissable signs?” Now we are bickering. “And there’s no driveway for ambulances.”

“Maybe the ambulances come in the back.”

We are in the intersection. She stops. The car behind us sits right on our bumper, about to honk. She takes her left. And we drive right past this sign without either of us seeing it.

In fact, there are two of these signs and we drive between them both.

We each have these moments, perhaps related to our intimacy of silence, when we decide something and don’t tell the other, as if the information will flash across the gap between us like a synapse. Which does happen sometimes. That isn’t what happens now. “Let me check,” I say, getting out of the car. I don’t ask her to wait. She doesn’t ask me if I want her to wait. When I come back to tell her that the emergency room is four blocks away, she is gone.

I just walk. I am wearing warm clothes. And as I walk, I follow the same route she just drove. Every hundred yards, once or twice a city block, is an enormous, unmissable sign that reads, EMERGENCY ROOM Beth Israel Deaconess Medical Center. Arrows point ahead. And then, on the last sign, they point right.

As we grappled with my diagnosis and went forward with treatment, I kept remembering how we missed the signs along our route to the emergency room. I missed other signs in the weeks before—night sweats, shortness of breath, increasing fatigue, and the devastating intensity of my fevers. When the information is so catastrophic, the resistance to knowledge is almost equally strong. You see and do not perceive. You hear and do not understand.