The day after my lung had been re-inflated, my head fell off. When Dr. A inserted the catheter between my ribs on my right side and then hooked it up to suction, my entire body had gone into spasm with coughing. As the coughing finally subsided, I was left with an intense muscle spasm in my upper right back that was so severe it caused me to hunch forward and to the right at all times. I couldn’t sit up straight at all. The pain of it had induced sweating, and nothing the nurses gave me alleviated it.

I spent that night, sleeplessly, trying to prop pillows in a way that would support me, as my entire body lurched into that awkward position. When I walked to the bathroom, I stayed hunched forward, my head parallel to the floor, and my knees deeply bent because I couldn’t straighten my legs. By the time the nurse came on for the morning shift around 6:30 and entered my room to check on me, I was listless again, at the threshold.

She asked me questions about how I was doing. My answers came in whispers through grit teeth, so she had to lean over to hear me. ‘Can we try a muscle relaxer?’

As she busied herself with ordering my medication, I felt the need to shift positions, and leaned forward a little more. And then my head fell. It simply dropped down, as though a muscle or tendon that was supposed to support it had failed. It hung there, uselessly limp. The nurse was too engaged to notice, so I reached my hands up, cupped my forehead, lifted my head back up and rested it on the bed behind me. I didn’t know what had just happened, but I felt like a series of disconnected, malfunctioning parts, taped back haplessly together. I wasn’t even sure there was a unifying thread anymore. Unwashed, growling at people through my teeth, I felt gnarled and savage, and could barely remember my own humanity.

The daytime nurse, Sadé, was a beautiful tall, young woman from Africa with a melodic voice, a bubbly laugh, and a kind, soft manner. She was an angel that day, as she handed me a small paper cup with a muscle relaxer pill, which I swallowed. At that time she asked what my pain level was on a scale of one to ten, and I replied, ‘Nine.’ A few hours later she checked on me. I had stopped sweating and could lean back into the bed. This time, when she asked, I said, ‘Four.’ She said she would prefer a two but I told her I was perfectly content. The relief let me rest some, and sleep during the day. No one bothered me that day about going for a walk down the hall.

I was alone, some time late at night. It was difficult to tell time. I could count hours of daylight, but in the dark there was no circadian rhythm. The nurse’s station, just outside my door was always buzzing, beeping. I didn’t mind, though. I thought it would be worse if I had a quiet room at the end of the hall. Then, in the dark of nighttime, when I was alone I might forget if I was alive. I was accustomed to waking to nurses caring for me while I slept. They took my vital signs, drew blood, administered medications via my I.V., fixed electrodes that had fallen off (causing my monitor at the nurse’s station to beep in alarm), dressed the many wounds. I learned to mostly ignore it all. On Friday night, however, I opened my eyes and Dr. A was standing at the foot of my bed. He was watching me with bloodshot eyes that told of the hours he had spent that day in surgery. His head slumped forward a little, between his broad shoulders. He was a large, strong man but at that moment he looked weary. Even so, he didn’t hurry, but stood there, as though this were an important part of his day and not to be rushed.

‘Dr. A,’ I croaked quietly. I was groggy, but I had something important to tell him. ‘I will get out of here. And I will be pretty and healthy again.’ I closed my eyes. The next time I opened them—it could have been a moment, it could have been an hour—he was gone.


Arriving at my parents’ home in the Catskills, the lower elevation bought me a brief reprieve. I sat on the couch in the living room, and my sister said, ‘You look better than I thought you would.’

‘Thanks,’ I muttered, not looking at her.

We sat in silence for a while until she blurted out in a funny voice, ‘You need to see the Wizard.’

I cocked my head to let her know I didn’t understand.

‘But you have courage,’ she continued, now smiling and chuckling to herself.

I stared at her blankly.

‘The Wizard of OZ,’ she said. ‘You need a new brain and a new heart.’ She changed her voice again, ‘But you have courage!’

Suddenly I pictured the cowardly lion brushing his tail to his face and started laughing. ‘I can’t believe I never thought of that.’

Every morning I went over to the rustic cabin behind my parents’ house and made a fire in the woodstove to heat it enough for yoga. On an April morning, I crouched at the open door, still wearing a hat and down jacket, watching the fire, waiting for warmth to shed some layers. From the outside, the cabin looked weathered but solid. Within, the ceiling was falling down, the roof leaked, and years of debris had piled up amid the dust. The cabin was musty, full of cardboard boxes and old furniture. I scanned the bookshelf and grabbed some of the dusty books I had convinced myself I missed. I rummaged through piles to see if there were any treasures I had forgotten, perhaps something decisive and beautiful that would bestow clarity. I swept three times but could not clear it out, so I laid down my yoga mat to practice in the middle of the mess that was part of my own past. The fire was finally going. As if on cue, the roof began to leak onto the space between my toes where I stood.

We were amidst a change of season and I was fortunate to be there at the moment when the Catskills turn pink. Before the buds emerge as green and explode into leaves, they first peak out in delicate pink and purple casings. Millions of buds on millions of trees on thousands of slopes, and—only momentarily—the mountains and forest look like they have been sprinkled in mauve fairy dust. It passes so quickly, as soon everything is rushing towards growth, copulation, productivity, and the messiness of unbridled creation. But I was lucky to be there for the quiet, soft preamble.

Tuesday was a morning of life. It started raining in the middle of the night and when I woke everything was wet and gray, the fog barely higher than the roof of the house. The thickening of springtime leaves made the trees harder to see through. When I sat up and swung my legs over the edge of the bed, I faced the window to the yard below the tree house, and watched a bear making its way down the slope, lumbering and swaying. Something startled him and he scurried off with a grace that belied his size.

Downstairs, I made a cup of coffee without turning on the light and stood at the glass door, looking on the back yard. The low light of the day illuminated colors the best. Somehow the quiet gray, shutting out the sunshine, allowed all of the understudies to shine with their own brilliance for a change. Brown leaves were deep, earthy, and easily distinguishable from the black soil beneath them. Bright spring greens on the ground and on trees burst nearly fluorescent. The drizzle stopped and I noticed a large, bright blue jay land on the tree closest to me. Then another joined it, then another, and more, until I counted nine blue jays in total lighting up the canopy. Still standing there, I spotted a large dark bird high above all the trees and craned my neck to see, recognizing a hawk. It circled overhead a few times and then two more joined it. I felt serenaded by wood sprites.

When I had arrived in the Catskills I had initially borrowed a little extra time. My body, accustomed to high altitude and less oxygen, felt a little less decrepit in the first week. Walking, I found myself going longer distances, coughing all the while, but it felt slightly less dire. And in yoga practice, I could actually move, and I settled into old familiar patterns with the breath. After a week, however, devolution set in and rapidly.

My yoga practice retreated to a seed. Each day I abandoned more movement, replacing with the breath, breath patterns, and imagining the internal forms. But soon, as in Boulder, moving was no longer possible. It placed too much demand on my heart in a rhythmic way, though my own organ had lost its rhythm. I would soon find myself devolving into anxiety about breathing. So I retreated and soon was merely sitting. Unlike many meditation instructions, I did not try to focus on my breath, which was only a source of anxiety. Instead, I tried to find some part of my body that did not feel ill, and focus on sensation patterns there. Oftentimes they were related to patterns of inhale and exhale, but I did not try to link or control them. It was the only way I could find to relax in a practice, which seemed like one of the only meaningful things I could do at that point.

The following Sunday was Mother’s Day. There were no more good days. Just sitting, every breath hurt as though I had millions of tiny shards of glass in my lungs and each surge of air irritated them and made my lungs not want to expand. My heart fluttered and pounded, as I felt myself gasping while merely staring out a window. My face was drawn, lifeless and the time had begun when I no longer liked mirrors.

I understood how people begin to die. Reverse metamorphosis, they retreat into the cocoon. Of course, now it’s old, partly disintegrated, mostly uninhabitable, and certainly does not provide the comfort it once did. I viscerally felt the different ways to be present. First, there was being aware of myself in my surroundings; the me amid the other. Then there was the presence of a minute part of what was me. After that, there was the understanding that I was not any of those cells and I could detach from them and still be. Although I had heard people talk about this, I realized that once you have felt it you know how you will die.

I grasped the concept of old age, and could imagine what my father felt like. I used to climb mountains, just like he used to sprint down a football field. I used to have dreams of what I would accomplish, as he did. But for both of us, the sphere of existence had shrunken. Success—always measured within the circle I had delineated around myself—correlated to my ability at that moment. I became materialistic with my time only.

I couldn’t help but wonder who my surgeon was. What kind of person cut open other people’s hearts? Did he have a life? Did he have a wife and children? What if he got sick? How can someone like that take a day off? Was he even human? When I met him, would he just be sizing me up, trying to decide the best place for an incision? Would I look like giant, beating heart muscle to him, and my mouth the aortic valve? Did he eat food?

One morning I awoke and my stomach was queasy. It wasn’t until half an hour later that I realized my surgery was one week away. With that thought, my stomach tightened and I recognized that my body had been responding to something it knew but I had forgotten. Then I remembered what my acupuncturist in Boulder had said. ‘The trick isn’t to get rid of the butterflies; it’s to make them fly in formation.’ It was my final visit with him, shortly before I had left Boulder. He had said matter-of-factly that the worst that could happen is I would die on the operating table. ‘And if you do,’ he said, ‘you won’t even know it.’ As the untamed butterflies flew, I realized that life was incredibly simple: to either be alive or not. Everything else was superfluous.

Despair, I felt, was the epitome of not being present. If I could only accept that this was really all I had; sitting in a dusty, cluttered cabin, closing my eyes and smelling the mustiness, feeling the warmth of the fire on my left shoulder, and that was a universe unto itself. There was nothing beyond that and the fact that I could feel at all was the greatest gift. Any aching in despair was either longing for something past or wishing for something in the future. But the present was perfect, by simple fact that I existed within it.

My older brother, Garan, had been taking me for daily walks. On our final walk by the creek, we saw a tree that had begun its growth at a forty-five degree angle to the ground. As it grew more, its trunk had turned horizontal and grew parallel to the ground. In the middle of the horizontal trunk a sprout shot straight upwards. And because that direction was more viable, it took over the main growth of the tree and became the new trunk. The rest of the original trunk looked like a thin branch after that, still continuing in its impossible parallel path.

‘Adventitious sprout,’ I said to him.

‘What?’ he asked.

I pointed. ‘When one part of the tree takes over the growth because the main trunk is growing in some way that’s not viable, it’s an adventitious sprout.’ It was one of our final walks.

And it came that mornings began slowly. My eyes would open, take in the room, my mind would bring itself up to date, ordering the sequence of events that told the story of why I was lying in my childhood room on a single bed, why my body felt so tired, and why the idea of standing to brush my teeth while looking in the mirror at dark eyes staring back was not enticing. For a moment my being was calm. Lying on my back, my heartbeat was barely noticeable. I had not yet begun to move or sit up, so breathing hadn’t become difficult.

My body quiet, I could hear through the open window the song of the rufous-sided towhee. It always reminded me of West Virginia and camping at the beaver ponds just below Spruce Knob in late spring. I would awake early to the sound of the Towhee, quietly slip out of my sleeping bag, and unzip the tent slowly just enough to duck outside. I put my sandals on, stood and put on the fleece I had grabbed, and stretched. We were camped just inside a stand of trees beside the pond and, as I walked to the edge, I faced a thick fog that began at water level and stopped just below the mountains on either side of the valley, where it gave way to a purple-gray sky. They were soft, old, treed hills, and just above the one to the West was the full moon, about to set, but still giving off its brilliance. As I stood there, in the saddle beside the peak in the east, the sun began to rise. For a moment the light from each was equal, and they danced a moment together, before dominance shifted. Once the sun prevailed, the fog morphed into tendrils that rose into the sky, dissipating into the now blue space. By the time everyone else rose, it was a different valley altogether.

Lying in my parents’ house, I wished the quiet of internal organs would stay with me, but eventually I would sit up and feel dizzy. My heart would start its irregular pounding, pushing against my ribs, so I could feel the intercostal muscles straining if I placed a hand against them. Then I would cough. Once, followed by twice, followed by an uncontrollable violent fit, feeling like a giant ball of phlegm should come up, but nothing ever did, and after whole minutes of my thinning body being racked and doubled-over, it would abate for a moment of gasping. I was still sitting on the edge of the bed when a second coughing fit began, and it bothered me mostly because I could no longer hear the towhee.

On my final Sunday morning before going to the hospital, I ate breakfast at the oversized dining table. My mother, father, Garan, and I each occupied a side, with a variety of newspapers spread between us, covering every bit of tabletop, while small plates of toast and eggs and mugs of coffee tried to squeeze out some space for themselves.

Garan looked up from his paper, stared straight ahead for a moment, and then turned to me. ‘It’s like an Incan sacrifice,’ he said.

‘What?’ my mother asked.

‘The Incans used to cut out people’s hearts in sacrifices.’

I nodded without looking up from my magazine.

My mostly deaf father rubbed his ear but did not appear to have heard anything. My mother sputtered some crumbs on her paper in an apparent cough.

Garan was still staring straight ahead. ‘It’s Friday the 13th, you know.’

‘Yeah, I know,’ I said.

‘Doesn’t mean anything,’ chimed in my father, obviously having heard that.

Garan ignored him. ‘I’m convinced that—because it’s Friday the 13th—the hospital will be dimly lit by flickering bulbs. You’ll arrive and the surgeon will say, ‘It’s just me here today: on these days we only have the skeleton team.’’

My father was mumbling something about ‘superstition.’

My mother looked up confused, ‘What’s Friday the 13th?’

Garan shook his head, exasperated. ‘Her surgery,’ he said slowly.

‘Oh,’ my mother looked at me, looked out the window, and then returned to her paper. But I was sputtering, coughing, and laughing hysterically.

I was conducting my own amputation. I had wielded the knife to cut off the pieces of me that had grown gangrenous or were simply in the way. I would sever the blood supply: no nourishment. Slice through the nerves: no communication. I would exfoliate the wound so that it turned round, smooth, leaving no trace of the form that was lost. I would call myself new, fresh, reborn. Which life was this? I could no longer remember—the one where I asked, Which life is this? The one where I surgically dismembered useless parts, wondered what would be left.