The entire world is a narrow bridge, but the main thing is not to fear.
—Rabbi Nachman of Breslav
***
I first began helping my brother kill himself in January of 2003. I flew home to D.C. when I learned that Charlie had grown sick enough to abandon his bachelor pad overlooking the National Cathedral and join my parents in their Georgetown townhome. He had been sick many times before, but he had always rallied. I went home to help him do just that.
My brother always greeted me with his trademark smile and hug, both infused with palpable joy, but this time I got a far more subdued welcome. Almost immediately, he began scrawling on a tiny notepad from the Springhill Suites. His lung capacity had diminished to the point where he could no longer speak and breathe at the same time—an alarming first for Charlie. I was still clutching his present, a navy blue baseball cap embossed with an alligator and the words “Bite Me,” an artifact from my new home in Florida. I slipped down next to him on the sofa and let the airport gift bag drop to the carpet by my feet. He handed me the notepad.
“I need you to go to CarMax with Dad to sell my car,” he wrote. I read his words, crafted in handwriting I knew as well as my own: tight, small loops linked to larger slopes and angles.
“Are you sure?” I asked. Charlie had an incredibly fun car, a red convertible. Every time I saw a Mazda Miata, I made a point of doing a fist pump and hollering “Chollycar!” out the window of my Civic.
He looked pointedly at the notepad. I handed it back, and he scribbled a reply. Sobered by the paleness of his skin, I watched his next message take form: “Costing me too much money.”
Charlie’s request made me think of a short story—an occupational hazard for English professors everywhere—called “Car Games,” by Frank Conroy. The story’s main character is a gray-haired man whose appetites are waning, about whom the narrator writes, “The truth is he doesn’t know why he no longer wants the car—anymore than he knows why he no longer wants to sleep with his wife.” The story echoed in my mind and made me frown. Charlie hadn’t driven nearly enough sports cars or slept with enough pretty women.
Charlie was born in 1968, before doctors were on the lookout for the oxygen-stunted fingers and other signs of cystic fibrosis (CF). His symptoms were attributed to allergies for the first five years of his life. The pediatrician instructed my parents to give him Robitussin to suppress his cough, a grave error for CF children, who should be encouraged to expel as much damaging mucous from their lungs as possible. If Charlie had been diagnosed at birth, my mother and father would never have risked having me two years later. I can’t remember a time when I didn’t know this.
In 1997, a successful double lung transplant had promised to extend his life by many decades. But there had been complications. By 2003, Charlie’s lung capacity had plummeted to 17 percent, much lower than it had been before his first transplant. He needed to conserve every breath, hence the communication via notepad, the oxygen machine, the wheelchair, the twenty-four-hour nursing in the basement “garden apartment” of our parents’ new place in Georgetown, and his prison pallor. His Miata sat under a foot of snow and ice.
I’m not a man, but I’ve read enough Frank Conroy stories to know what it means when a certain type of man stops caring about his car. At least in America, cars have something to do with the life force.
“All right, I’ll do it,” I told my brother. “But after you get your new lungs and you’re back terrorizing pretty girls on the road, I get to help you shop for a yellow Porsche Boxster. Deal?” His right hand lay still on the notepad as he fixed me with a look I didn’t recognize and didn’t want to know. I couldn’t return his gaze, so I took inventory of the items that defined his convalescence: oxygen tanks, crossword-puzzle books, get-well cards, newspapers, fleece-lined slippers. Photographs of famous people decorated our parents’ “ego wall.” Their dynamic careers as Washington insiders punctuated our lives as regularly as CF. From their picture-frame perches, Henry Kissinger and Ted Kennedy watched me pretend not to notice my brother’s flattened affect. For the first time, I pitied him. I pretended to care about the status of dinner just so that I could leave the room. I had never wanted to leave his side before.
“I think Charlie’s depressed,” I announced to my parents upstairs in the kitchen. My dad was reaching into a cabinet for his favorite crackers. As soon as the words left my mouth, his hands dropped to the counter before he turned to look at me. His eyes became wet and he began tapping his fingers against his bum hip, one of his anxiety “tells.”
“That’s because he knows he’s not going to survive this,” he whispered—part gurgle, part whimper.
I felt my temper ignite. It had only been a few months since my last visit, but in my absence, Team Tolchin had grown soft. My father, the Tolchin family patriarch, was violating the Cardinal Rule of Charlie: Strength and optimism in the face of medical trials. Charlie had fought so hard, for so long, with an Olympian’s focus on health. At the age of eleven, he set up a gym with free weights in our basement, determined to put some muscle on his pale, concave torso. At twenty-seven, he took up ice hockey with thirty percent lung capacity while he waited for his first double lung transplant. He would play for five minutes, cough against the boards for ten, and repeat the cycle for hours. His face gleamed with pride and bloodlust.
If Charlie had finally lost his focus after all these years, well, no wonder. I’d have lost it after about fifteen minutes wrestling with CF. We had to help him find his resolve again and get back his health, not stand there crying. I looked to my mother for backup, but after just a few months of care-taking, she had the aspect of a much older woman.
Charlie involved me in the car transaction because our father couldn’t squat down low enough with his bum hip to drive the Miata the twenty-two miles from Washington to Maryland, where CarMax gave people cashier’s checks for their used vehicles. So I was the one who hurtled down I-270 in the Miata, glad Charlie couldn’t hear me grinding his gears from lack of practice.
He had given me my first and best driving advice. One afternoon, he caught me honking at other cars long after the noise might have prevented an accident. Fresh from driving school, I was appalled by how few people actually signaled before changing lanes. “Karen, Karen,” Charlie admonished me gently. “No punitive honking.” Because of Charlie, I sit up tall in the driver’s seat (as opposed to slouching like our Grandma Dorothy) and I never drive slowly in the left lane. I still use the horn too much, but I always feel guilty about it afterward, which is a sort of progress.
While the CarMax appraisers went to work on the current value of the car, my dad and I sipped burnt coffee from Styrofoam cups in the waiting area.
“We bought the Miata on a perfect spring day,” my dad said. “Cherry blossoms straight out of central casting.” The car was an automotive declaration of independence. Thanks to his new lungs, Charlie’s daily health routine went from five hours to five minutes. He got a full-time job in Washington, did fundraisers for CF and organ donation, and dated hipster beauties that worked for nonprofits. His (hypoallergenic) standard poodle Bogart rode shotgun, and from behind, looked just like a curly-haired brunette. Charlie took great delight in the looks of astonishment they got at red lights, when Bogart turned and revealed a long black snout covered in fur.
“That was a great day,” my father continued, tightening his lips. I saw that I was going to be all alone in the Cardinal Rule of Charlie, and then realized I was no better at mustering strength and optimism. Charlie usually rallied the troops. In his absence, we all became disoriented.
If Charlie died, I would be alone in many things. At some point in a future that was no longer unimaginably distant and opaque, my parents would leave me, too, and I would be an orphan in the world. I saw myself walking an icy, post-apocalyptic wasteland—no brother, no parents, no family to love me. And who, if not family, would love a punitive honker? My mood tilted. I slumped in my orange chair of molded plastic and began to cry.
I didn’t want to accelerate my father’s own morbid spiral, or disturb all of the happy families around us who had come in search of minivans, so I did what I have always done when I cry: I hid. I ducked outside and began to wander around the sales lot. I was wearing open-toed Floridian shoes without socks, having somehow forgotten my snowy northern upbringing, and I kept stubbing my toes on snowdrifts. Not only would I be condemned to walk an icy landscape for the rest of my days, but I would have to do it without proper footwear. A bumbling, flip-flop-wearing orphan. Would there be no end to my suffering? As I tried to control my sobs, salesmen kept popping out from behind sport utility vehicles and sedans.
“Do you like this one? Wanna take it for a drive?” I hoped that they attributed my red eyes and running nose came from the chilly temperature.
“Just looking, thanks,” I said, over and over again. Looking for what? What were the odds that I would find the courage to survive my brother’s death in a Jeep Grand Cherokee, even one with an extended warranty?
My father and I drove home together in silence in his silver Jaguar, a cashier’s check in a plain envelope between us. My mother would have to take it to the bank and deposit it into Charlie’s account in what might be an optimistic gesture. Charlie wouldn’t be able to go to the bank around the corner without new lungs.
For the first twenty-nine years of Charlie’s life, the violence of his coughing fits had routinely stopped all conversation in public places. Charlie insisted that we play it cool, but I never got used to the loud, wet sounds, or the vein-popping, purple-headed sight of him bent over in a fit. Strangers gave us reproachful looks. In the dining room of North China restaurant in downtown Bethesda, my parents and I sipped our soup as if nothing was amiss while the crowd around us wondered if they should call an ambulance or a social worker. After a few minutes, I buckled. “Are you okay?” I would ask loudly for the assembled crowd. Charlie would shoot me a disappointed look from bulging eyes.My brother’s cough produced large gobs of greenish-yellow slime. He would cough in his sleep sometimes, and the walls near his pillow became glazed with it over time. I once tried to scrape it off with a butter knife. I didn’t want any of his friends to notice and be repelled by it, but by then it was part of the wallpaper. It never mattered. Charlie never lacked friends. He routinely got voted class president because he genuinely cared more about others than himself and they knew it. Charlie loved to dance, remembered every bawdy joke he was ever told, and got daily calls from friends seeking his wise counsel. He was a more sincere, real-life Ferris Bueller: exuberant, funny, beloved.
Charlie got my full allegiance. Our parents showed us both great love, but they were a complete unit, sometimes maddeningly so. They were a liberal Jewish version of Nancy and Ronald Reagan. It made sense for us to develop as a parallel duo, Nancy and Ronnie in miniature.
For the longest time, we were happy.
Four years after the transplant, Charlie developed Burkitt’s lymphoma, a complication associated with the one slight donor mismatch of his transplant. Charlie took the news as he always did, stoically, resolved to do whatever it took to beat the cancer. He lost all of his hair to the chemo, which he infused in a portable IV under his suit while he continued to work. When he was pronounced cancer-free, thwarting the last in a long line of premature death sentences, his enthusiasm didn’t seem grand enough to match the moment. He seemed to know what it would take the rest of us a year to figure out: that the chemo had sent his new lungs into permanent rejection. He registered for a second double-lung transplant, for which the survival rates were exponentially smaller. Apparently, there was only so much a body could take.
Two months later, I was crying at CarMax. Less than a year later, I learned the meaning of real anguish.
***
Eight months after we sold the Miata, I flew to D.C. for what was supposed to be a routine visit. I would stay with Charlie while my parents escaped to their Vermont condo for a much-needed break. Charlie was especially miserable. As if breathing at seventeen percent weren’t punishment enough, he had contracted shingles, a nerve irritation caused by a virus that can produce an excruciating rash along the spine. In the clutches of the Ghost of Chickenpox Past, it was obvious that Charlie couldn’t get comfortable for love, money, or calamine lotion. A new pain-management specialist had suggested an increase in morphine, which seemed to help.
I thought he might be more comfortable if I helped him wash his hair. He had been refusing the nurse’s help in this regard because he could no longer recline. I covered him in towels and used pitchers of water and baby shampoo. At one point I tried to tip his head back slightly, to keep the suds out of his eyes. He gasped and clung to me like a child. I was shocked to see how infirm he had become.
My parents left on a Saturday afternoon. Less than a day later, at 2:00 a.m., I woke up imagining that I’d heard a sharp cry. I ran down four flights of stairs to my brother’s basement lair.
“Charlie? Was that you?” I asked. His eyes communicated the terror small children experience when they wake fresh from a nightmare. His oxygen mask had gone askew, and he was suffocating. I still have no idea how he summoned the air to cry out, and how I heard it. I fixed the mask over his face and held his hands for a while as he caught his breath. “All better?” I asked, but his eyes retained their terror. It was much worse than I realized. I wanted to sleep on the floor next to his bed for the rest of the night, but his nurse had stirred from her sleep and assured me that she would keep vigil.
I was deeply ashamed that I hadn’t taken a leave of absence from my Florida job and come to nurse him full-time. I had told myself that I couldn’t leave my job, college teaching positions in English being as rare as organ-donor matches, but the truth was that being with Charlie meant watching him suffocate to death.
Later that morning, Charlie began to spit up liquid the color and consistency of used coffee grounds. I asked if he would let me take him to the hospital. He shook his head as vigorously as he could.
“I don’t want to go back there,” he wrote on a scrap of legal cap. “There’s nothing they can do for me short of putting me on a ventilator.” He didn’t want to be kept alive artificially because it would hurt his chances for a future transplant. Charlie had already signed a DNR or “do not resuscitate” order at Georgetown University Hospital, which tied their hands in the event that he “coded.”
“Maybe they can just make you a little bit more comfortable,” I said as the afternoon wore on. “Please.”
Georgetown University Hospital is one block from my parents’ home, but it took a stretcher, three men, and an ambulance to carry my brother from his chair in their basement to the ER. By midnight, doctors had convinced him to allow them to insert a nasogastric tube to drain the liquid. The brown coffee grounds signified blood and they weren’t sure where it was coming from. As they prepared to wheel him off for an MRI, I let go of his hand. He snatched it back.
“Don’t leave me,” he croaked.
“I won’t,” I said.
“Sorry, but you can’t go with him,” a nurse told me. Charlie began to cry. I’d never seen him cry before.
“I’ll be right outside,” I said, willing him to believe me with the gentlest look I could muster. They injected him with a medication to relax him while we waited for the MRI tech, and then it started.
“You have to help me die,” Charlie said.
“Jesus, Charlie.”
“I mean it. You have to help me die.”
“You don’t mean that. You’ll be fine.”
“Listen to me,” he said. “Help.”
As soon as the doors closed on the MRI, I called my parents. They had just arrived in Vermont after a ten-hour drive.
Even with the nasogastric tube, Charlie kept spitting up blood, so my mother’s friend Linda came to help, and we took turns holding tissues under his mouth and stroking him on the arm.
Charlie was in bad shape, but no one seemed to think he was dying. I periodically relayed that fact to Charlie, who was slipping in and out of consciousness. He seemed cheered. “Don’t let them ventilate me, it’ll ruin my chances for a transplant,” he said. Then a few minutes later, the contradiction: “Why won’t you help me die?” We had the same maddening reversals moment to moment over a period of twelve hours. Was I hearing the pain, the drugs, or my brother? I could no longer tell.
I bawled openly in the hospital cafeteria. A worker, a middle-aged Somali woman with a high forehead and kind eyes, put her hand over mine.
“Give it up to God,” she said.
In the lobby of the hospital, I tried a chair massage to loosen the tangle of muscles that had me wearing my shoulders like earrings. Usually, massage was my favorite thing, but I found that it had lost the taste for it. It was like having sex with someone after the relationship has tanked: wooden and joyless, no comfort or release to be found.
“I can’t take this,” my dad said later that night, tapping his hip.
“I know what you mean,” I said.
“I don’t,” said my mom. She shot us both a horrified look. “I can take this forever. I can take anything as long as…” As long as Charlie is alive, we all filled in silently.
***
A middle-aged doctor with blond hair sat down with us late Wednesday afternoon. All of Charlie’s organs seemed to be shutting down, and his limbs were beginning to swell.
“Charlie knows what’s happening here,” she said, resting one hand gently on his bloated calf, “and so do you.” The goal was now just to make him as comfortable as possible.
“We love you, Charlie,” we said over and over, all day, touching his hands and his feet.
I’d never attended a woman in labor, but I had the strange feeling we were doing something similar with Charlie. We were ushering him through a passage. You can do it. Push. We were helping him along with the hard work of dying, letting him know he wasn’t alone. We were telling him through our touch that he was loved, but that it was okay to go.
On Thursday morning, my mother broke abruptly from the script. She began to talk to us about changing courses and taking extraordinary measures. She wanted to reverse the DNR order. “It’s not right,” she said. “We can’t just let him die.”
When our friend Linda arrived for her daily visit, I took her aside.
“When I was in this situation with my father,” she said carefully, “I asked one of the nurses, ‘How much morphine have you been authorized to give him?’ She told me, and I asked if she could administer it all to him in that moment. She did, and he passed away later that day.”
I thought about it for a moment. I saw my mother talking about the DNR reversal with Charlie’s doctors just a few paces down the hall. I wanted to give it up to God, but what if He was too busy to notice my brother’s pain? What if it never stopped? I took a deep breath and asked Linda if she would go with me to the nurse’s station. I held her hand as we walked there.
“How much morphine have you been authorized to give my brother?” I asked the nurse, who began to cry.
“We wondered when you would ask us that,” she said, brushing her eyes with the back of her hand. A few minutes later, she walked into Charlie’s room. My father, mother, and I sat around Charlie, stroking his hands and murmuring words of love to him. The nurse made eye contact with me and gave a small nod before injecting a small vial into my brother’s IV.
A rabbi friend of my parents happened to be visiting. I had never met him before. As Charlie’s vitals slowed, Rabbi George began to say some special prayers for the dying, the ancient Hebrew precursor to Catholicism’s last rites. We stroked Charlie’s hands and watched the monitor until it seemed like one heartbeat a minute, and then one every other minute, until they stopped altogether.
“Has my brother died?” I asked the nurse.
“I think so,” she said. The pace was so gradual and the room so still, I couldn’t tell. Charlie’s hand in mine was still warm.
Our rabbi friend began to talk about Jewish funeral arrangements right there at Charlie’s bedside, but I stopped him.
“If there’s any chance that Charlie can still hear us, I don’t want ‘coffin’ to be the last word he hears,” I whispered. I couldn’t muster poetry, but I could say the word ‘love’ over and over. Rabbi George nodded and stepped out into the hallway.
***
I had been locked in crisis mode for as long as I could remember. We had solved the crisis of Charlie’s pain, but now what? It hadn’t occurred to me on some primal level that there would be no next crisis, no future conversation, no further contact with the brother I had known for thirty-three years. He died two weeks shy of his thirty-fifth birthday. I hadn’t allowed myself to look more than ten feet down the path, so I was staggered to find I no longer had a brother. I was like Wile E. Coyote: I had been running for so long, I hadn’t noticed when the road ran out on me.
The night before the funeral, I brought my air mattress into my parents’ bedroom. After a few hours, I heard my mother begin to talk like a woman in a trance.
“I can’t stand it, I can’t stand it, I can’t stand it,” she began in a low voice.
“You must,” my dad responded, pounding on her torso rhythmically as if to revive her. “You must. I need you. I can’t survive this without you.” I listened quietly in the dark and wondered how many times they had performed this particular duet. It was more intimate than sex. It sounded like something that had happened before, something that had been happening for decades. I swelled with compassion for them, and felt myself truly forgive them for all their trespasses, real and imagined.
I miss my brother, I miss my brother—the thought began to come in waves. Hysteria was building in my throat but I kept it down. I suddenly understood how people could go crazy over grief, screaming, their hair turning white overnight. I wished we were Greek so that I could tear at my clothing and have a good, dramatic wail, preferably on a sea wall. Yet such a dramatic gesture would have disappointed Charlie.
Strangers want to know how Charlie’s death could have come as a surprise. Didn’t we know from the beginning? Charlie had eluded the proverbial angel of death so many times, for so many years. We had gotten spoiled.
***
Rabbi George found me hiding in the back of the synagogue before the funeral.
“I hear you could use a conversation,” he said.
“I killed my brother,” I said, almost by way of greeting. He guided me into his office and shut the door. I took in the 1970s Jewish art, latch-hook rug paintings and watercolors of the Wailing Wall, and realized how long it had been since I had seen the inside of a temple.
“Wow,” he said. “You’re that powerful? You give and take life? I thought that was God’s job.”
“You know what I mean. I was the one who asked for more morphine, I hastened the end. Now, I have no brother.” It had been a long time since I’d been to Hebrew school. I wondered if I was even human anymore. Had I become some sort of demon? Was there a special room in hell for brother-killers where I would have to play chess with Cain for all eternity?
George told me a Talmudic story about a woman who cooked and cleaned for a beloved rabbi. At the end of his life, his students and friends came and chanted prayers over him at all hours. The woman loved him and saw that he was in great pain. He couldn’t die because all the prayers were keeping the angel of death from entering the house. So she threw a pot out the window. When it crashed on the pavement, everyone ran over to the window to see what had made the noise. In that instant, the rabbi was able to die.
“You’re a pot thrower,” George said. “Your brother was suffering and you used your strength to help him.” He told me that generations of rabbis have debated the meaning of the story. They agreed that the servant did a holy thing because she acted out of love.
I rolled the idea around in my mouth for a while. Pot thrower. Throwing pottery was sometimes a creative act. My literary nature savored the metaphor for a moment, but then I remembered what we were talking about. I couldn’t see what I had made, only that I had scattered the shards of something far more essential than a pot on the pavement.
George watched me for a few minutes with pitying eyes. Finally, he pulled a copy of a red leather book from his shelves called Kol Haneshamah: Prayers for a House of Mourning.
“People need words and rituals to get through these times,” he told me. “Why don’t you see if this might bring you a little comfort?” I took the book from him with gratitude.
***
Charlie was in a shroud inside a simple pine box. Many people stopped to touch it before it went into the grave, but I could never get close enough. I almost had the opportunity, but held back because I thought people might see me reaching for the coffin and think I was losing control and planning to jump in the grave after him, like a wife on her husband’s funeral pyre. But I wasn’t a wife, just a sister, and I didn’t want to create a scene. I quietly hung back and joined in the custom of throwing some dirt on the casket. Yet I regretted not placing my hand on the wood and feeling it for myself.
Back in Florida, a horrifying thought occurred to me: What if I stopped being able to recall my brother’s laugh, or some other essential quality? If the price of healing from a major loss was oblivion, I didn’t want to heal. To battle any potential erosion of memory, I began a nighttime ritual. I took inventory of all the little idiosyncrasies that made Charlie unique. I thought of weird things like his fascination with the French word “avec,” and the fact that he knew all the words to the Sugar Hill Gang’s “Rapper’s Delight.” I was constructing a Chuck Close painting of him in my mind out of odds and ends. I had no other choice.
A month after Charlie died, I attended a memorial service for the husband of a colleague. We all seemed to be going through a season of loss, attending funeral after funeral. There were palm trees instead of pines at the cemetery, along with many other differences, but Paul was Jewish and had the same pine-box casket. The moment I saw it, I knew what I had to do.
Like a pervert poised to cop a feel, I looked around to make sure no one was watching and then I put my hand on Paul’s coffin. It looked as if it had been buffed smooth as a river rock but felt rough as a cat’s tongue to my fingertips.
“I’m sorry, Paul,” I whispered, rubbing my finger across the grain. “I miss my brother.”
***
An earlier version won an Honorable Mention, 2011 Penelope Niven Creative Nonfiction Award, International Literary Awards, Salem College Center for Women Writers (Judge Megan Daum), but this piece has not been published previously.
***
Rumpus original art by Lara Odell.
