I’ve only rarely worried about death. The one time I actually was dying in a hospital for a while, I wasn’t worried about it. I was too busy taking in every detail around me, trying to remember it all. What did that sign in the room say? What was the last thing that EMT said to me? How would I describe the (gritty, syrupy, black) taste of the liquid charcoal poured down my throat? Every detail becomes important. Journalist Jean-Dominique Bauby, author of The Diving Bell and the Butterfly, exemplified this better than anyone as he sat in the hospital and painstakingly wrote a memoir by blinking his eyes, the only movement he could make. He blinked out every adjective because every detail was important. In the hospital, where the stray beep of a machine immediately triggers emergency thoughts, everything matters.
Writing affirms life. I had been having a panic attack for 30 hours, had been shaking so hard that my spoon clanged against my teeth when I tried to have yogurt. I was at work that day, my hands clattering all over the keyboard, my head going so fast as I tried to slow down for the minutiae of my job. I left work early to go to the hospital. In the waiting room, my thoughts suddenly took on a direction, not merely speed but velocity. Now what mattered was the short story I was writing on. What job should my narrator have? Could she be a florist, a baker, a secretary? I made a list of possible ones, finally settling on tour guide, which I circled in my green notebook. I don’t know what would have happened to me if I hadn’t had my notebook that day. Curled up on an ER cot, I listened to my iPod and jotted down details. I saw police bring in a handcuffed drunk. They cuffed him to the bed next to mine. I didn’t know why he was in cuffs; I just heard him threaten the Weymouth Police Department repeatedly at top volume. I was immediately not only curious but engrossed in his story, in the absurdity of the whole situation. I was so fascinated that I started recording him on my cell phone. I listened to him, letting his whiskey-inspired profanity and volume wash over me, drowning out my headphones. I heard him slowly sober up, heard the f-word gradually fall out of his vocabulary. He inevitably pulled back the curtain between us and asked what my name was. I told him it was Josephine, an in-joke I have with myself. For whatever span of time I was there, I was Josephine with the green notebook. I was listening. I was taking notes.
The last time I was in a hospital, the first thing I reached for was scrap paper from my purse. I was putting on a gown, and I started thinking how the only times we use the word gown, we mean either a hospital or a wedding, and that thought was fast becoming a poem. This gown was blue plaid. I have never worn a wedding gown. In the hospital, every detail is important.
“Physical pain has no voice, but when it at last finds a voice, it begins to tell a story,” writes Elaine Scarry in The Body in Pain. The voice of my physical pain was not a scream or a groan; it was me muttering to myself as I tried to find the perfect slant rhyme for gown. It was me remembering that I had once had a lover on Twin Flower Lane, me trying to write out all the details of an Independence Day we’d spent together in his bedroom studded with graphite cutouts of birds he’d made. Syllables fell along with every precious drop of morphine blissfully entering my bloodstream in an attempt to soothe the sharp scissoring in my abdomen. And when they took me to have an ultrasound of my belly, my pain was working on another story. In a short story I’ve been writing, I have a mermaid getting an ultrasound of a wound, and, having never had an ultrasound, I was so glad to finally have a chance to get the details right. There were pictures of palm trees on the ceiling to look at. The technician was playing pop radio, and Evanescence’s “Call Me When You’re Sober” was blaring when I was wheeled in. The ultrasound goo was surprisingly warm. The technician put a paper towel over my breasts so the goo wouldn’t cover them.
I wasn’t allowed to eat that night or the next. I was on a steady diet of intravenous saline and morphine with occasional snacks of ice chips. My first nurse was Diane, about to go on vacation in Door County. Then my nurse became Nicole. Not Nicole the nurse, but Nicole who lives in Sun Prairie but gets her hair cut at Cha Cha in Madison, just across the street from my apartment. There was Jessa the night nurse, Jessa who followed the rules too much, who checked the color of my urine and made me do breathing exercises so I wouldn’t get pneumonia and made me use the compression hose so I wouldn’t get blood clots. And through this all was me in the adjustable bed, constantly ringing the nurse bell to ask for more paper when my laptop battery started to run low. When the morphine was working, I would flounce onto my now pain-free stomach and type out the words to a book review, mumbling lists of synonyms for “breathtaking” aloud.
A housekeeper came in to change the linens and said, “So, I hear you’re getting your gall bladder out tomorrow.” The doctors hadn’t told me that yet. I was scared. I was lonely. I was grumpy. I was hungry. I was in love with the idea of being cut open. I was in love with the idea that they could use cameras to rearrange my insides. It mattered how many millimeters each incision was, how many there would be, and where. It mattered how, after the surgery, a huge bandage covered my belly button, and how I’d never before realized how important it was to be able to touch my belly button whenever I wanted to. After a liquid dinner and a dilaudid IV, I was able to think about the other things that mattered. I thought about how I was lying under a white sheet, and how in photographs we see white sheets covering dead bodies, not live, healing ones.
I didn’t write about the white sheets until the next time I was in the hospital, two weeks later, when my stomach started screaming at me again. I got reacquainted with dilaudid and opened my laptop. This was the day after the shootings in Oslo, the day after Amy Winehouse died, the day of too many photographs of white sheets, the day I’d, ironically, been reading Sontag’s Regarding the Pain of Others.
Elaine Scarry also writes that when “One hears about another person’s physical pain, the events happening within the interior of that person’s body may seem to have the remote character of some deep subterranean fact, belonging to an invisible geography that, however portentous, has no reality because it has not yet manifested itself on the visible surface of the earth.” My job as a patient is to describe my pain, to give it a visible geography by saying the right words, unearthing the truest facts of my condition via the precise adjectives: dull, upper left, an eight on a scale of one to ten. “People want the weight of witnessing without the taint of artistry,” Sontag writes. Doctors (and undertakers) are the ultimate witnesses of our bodies, understanding our own selves in ways we never could. Yet, they can never occupy our pain, or anyone else’s. In that way, doctors are just like the rest of us. All we have is witnessing. All we have is writing.