An Enlarged Heart (6 page)

September

T
he Thursday before I received a telephone call from the children's school. There was a new family coming to the school. The elder child, a boy, would be in my children's grade. That year they were eight, or nine. They were in fourth grade. The school that they went to then was on the grounds of the Cathedral of Saint John the Divine, which was a few blocks from where we lived, in Morningside Heights, north of Central Park. To get to school we walked a few blocks south, past the Church of Notre Dame, which was built on a piece of rose quartz, and skirted through the back lot of the cathedral. At that time the back lot was a mess. Weeds grew helter-skelter through the broken tarmac. The blacktop itself was littered with stone carvings of angels and griffins; a stone-carver's workshop opened onto the back lot. It was managed by a man called Simon, who wore his hair in gray corkscrew curls. He was continually covered with marble dust. He had a fine face that verged on beauty, and looked like an angel who had fallen to earth.

Every morning we walked through the stone yard and then through the north transept door of the cathedral, and crossed the apse. Our neighbor also brought her child to school. She had a little dog, and the dog crossed the cathedral with us. Later, the north transept door was locked, and dogs were no longer allowed to walk through the cathedral at 8 a.m., but then we had the freedom of the place. There were peacocks on the close and at that hour they were often screaming. The year before the graduating class had added an albino peacock to the flock. He had ceased to be a marvel, but it was still possible to be caught, unawares, at the sight of him. That was the first year that the children sang in the cathedral choir: you had to be nine, so I guess they were nine. Three afternoons a week they practiced in a room with casement windows in the south wing of the cathedral, which had once been an orphan asylum. On Sundays they sang at the eleven o'clock mass. Sometimes they also sang at evensong. They wore crimson robes and white collars, which were starched. Later, they would hate everything about choir: the rehearsals, the too-hot robe, and they wrote us long letters arguing their position which they read aloud to us at the kitchen table. By then we had moved to a house below the park which we could see from our window, and the cathedral and the life of the school had become more remote to them, and we drove them to school instead of walking through the apse. But that was later.

Then, it was the tail end of summer. It was very hot in the city. The leaves on the trees were dry, and when even a slight breeze moved them they rattled, as if a snake were moving through the branches. The sprinklers were turned on in the pocket park across the street. Water sizzled when it hit the blacktop. It was too hot to go without shoes, and when I took the children to play in the city sprinkler I kept my rubber flip-flops on. The ice cream truck jangled on the corner. It was the summer that we discovered that the owner of the truck was selling crack out of the back. As we did every summer, we had spent August at the beach. As usual, when we returned to our building, with its cool black-and-white-tiled lobby and our apartment with its long hall, and its view of the sprinkler and the ice cream truck, it was for the children as if we had never been away, or as if we had been away for a day and come back. On that Thursday we had been back four days. The telephone rang when we were walking in the door, and as I picked up the phone I was admonishing the children. I did not want water in the hall. I had left a fan on in the kitchen and the mail, which had been left on the counter, had blown down on to the floor, and the children were stepping on it with their wet feet. The voice on the other end of the telephone was known to me: it was the receptionist at the school, who was already at her desk although school had not officially opened. She wrote poems; it was that kind of school. She also acted, informally, as the school nurse—it was a small school. One of the children, who was prone to stomachaches, often took up the small cot behind her desk, especially when toward winter it got dark early. She told me about the new family, between pauses while I tried to get the children to pick up the mail, and to get the wet jellies off the baby, who was two. She gave me a telephone number, and said, “Promise you'll call.” I promised. The idea was that before school opened these children would have met my children, and the mother, whom the receptionist said seemed shy, and whose husband worked long hours, would have met me.

It was Thursday afternoon. On Friday my mother called and suggested that the older children visit her on Long Island. It was hot, she pointed out, and they could swim in the pool. We drove them out that evening through the weekend traffic and then drove back into the city with the baby strapped into her car seat, and had drinks in the kitchen with a lot of ice. Then we put all the fans in the apartment in one room and the three of us slept fitfully. The next day we decided to go to the beach, to Sandy Hook, where we had never been, and we piled the baby back in the car with juice and towels and sandwiches. I missed the beach. Whenever we returned I pined for weeks. During those weeks I had fitful, disjointed conversations with my friend Anne, who rented a house near our rented house every August. We discussed, aimlessly, why we lived in the city, and what a bad idea that was until the weather got colder and we were distracted. That Saturday, the drive south into New Jersey took two hours, and the parking lots were full, except for one at the end. The baby ran into the waves and we pulled her back. I didn't think of the phone call I was meant to make, or even the other children, who were with my mother and, I assumed, adequately taken care of. The water was as warm as glass, and after a while we piled back into the car and drove back into the city, which by now was so overheated that from the highway it looked as though it were wreathed in smoke. When we got home we ordered Chinese food and the baby ate fried rice, which is what she orders to this day, and in the morning my husband drove out to fetch the children before the traffic got really bad. The next morning it was Monday, and I thought: I will meet her at school, and we will exchange numbers, because I hadn't called. The children wore uniforms at their school and, of course, the ones they had worn before the summer did not fit, but
would have to do,
which both they and I saw as further proof, as if any were needed, of my general mismanagement and inability to acquit myself as a bona fide mother, a mother who could make timely phone calls, who never broke promises, who would have ordered new uniforms in June, in the correct sizes, and in plenty of time, before we went away, to exchange them if necessary.

The next morning was school. We set the alarm and the children struggled into their too-small uniforms, and we set out down the street in the sun, which was already hot. Because it was the first day of school, the sitter, who took care of the baby, came early, so that I could walk the children to school and pay full attention to their new classrooms, where their names were written in construction paper, cut to look like bubbles, on the glass door. The new boy was in Jack's class. His uniform fit. He was shy, but friendly. On the way to school I had managed to remember his name, and to ask Jack to be especially nice to him. Think what it would be like to come to a new school, I said, and not know anyone! When the children were settled in their classrooms I walked out of the door of the school and down the long drive that ended at Amsterdam Avenue. It was 9:05 in the morning. The path had been embellished with late lilies, orange and cream colored, with black throats. At that time I had an office in the triforium of the cathedral in which I could sit by myself and write. It had been given to me by the Dean, whom I loved. I walked on the sidewalk on Amsterdam and crossed over to the wide flat steps of the cathedral, which as usual was flanked by tour buses. There was a group of Chinese tourists fanning themselves on the steps, and as I walked past them my way was blocked by a woman whom I knew was crazy. She was dressed in a white djellaba and a gold turban and she wore no shoes. She often spoke in tongues, and I assumed that she was speaking in tongues now, although it did occur to me in those seconds that she had never touched me before, as she did now, holding on to my arm with clenched fingers. Later I would notice I had a bruise but it was much later, weeks later, that I remembered her hand on my arm, and her knuckles, iron under the stretched skin.

She let go of my arm when I walked into the cathedral's cavernous cool, its smell of mold and incense, and something else my children called bat-wing, and there was Christopher, who worked in the cathedral, moving the chairs. The Cathedral is huge, there are a lot of chairs, and it is his job to move them. He looked at me, and said,
Oh, miss,
and I said
What's happened?
And then I knew.

In the days and weeks that followed in New York the heat did not let up. Sometimes it rained. Because no one could bear to be apart we had picnics with the children in the park, to which some people did not come because they thought the ash would cover us, and then as it got colder we sat in each other's apartments and cooked elaborate meals, and fed the children pasta, and decided whether we would stay in the city or whether we would leave. For weeks there were memorial services at the Cathedral or downtown almost every day, and along with their book bags and baseball mitts and science projects, the children carried their crimson robes and starched white collars to school, where they were excused from classes to sing. Though I tried to invite the little boy who was new to the school to come and play, he would not come because he would not leave his mother. We did not meet his father, who that morning had disappeared like others into—nothing. Earlier that week, before school started, he had taken her wedding ring to a jeweler because he wanted it inscribed for their anniversary: he had the ticket in his pocket and though there was a story in the newspaper about it, it was never discovered where he had taken the ring and so it was lost. Because she refused to believe he was dead the funeral was not held for some weeks, and she insisted on an open empty coffin. I went to the funeral with a friend whose husband himself was dying, of cancer, and on the way home she told me that she wasn't going to let him die, what she said was “I am going to lay down in the middle of the road.” He did die a year later and she died, too, shortly afterward, one falling after the other, but we didn't know that then, as we didn't know so many things—what had happened or what would happen. When later that winter, after the Cathedral had almost burned to the ground, which is another story, my hands were cold after peeling some shrimp in the kitchen and my wedding ring flew off, and the children hunted for it all over the floor until Jack found it by standing in his stocking feet on a chair, on top of the icebox, I thought of her missing ring, and another story, of a woman in a novel who searching for her wedding ring under an icebox was electrocuted.

That weekend in September when we went to Sandy Hook, because I was dissatisfied with my life, and angry at having to live it, and to have summer end, we drove down through the long cattails and I was unhappy because the beach that I love doesn't have cattails. I didn't like the boardwalk, or that the water was warm. The baby didn't care. She was thrilled to be at the beach and to see the tiny crabs burrowing in the sand. She drank her red juice right from the bottle, and it made a red mark around her mouth, and I remember being tired of juice and juice boxes, and the heat. The baby tracked sand over the towels with her wet feet, and I looked across the water to where we could see New York City, gray with dust rising up in its stone cauldron, and I said, “The last thing I want to see when I go to the beach is the Twin Towers.” That is what I said.

An Enlarged Heart

I
t began with a cough. Her brother had a cough. And, after all, what was a cough? They had all had them. In the winter, they passed them around like sweets. Enough coughing meant no school. Although sometimes we sent them off anyway—risking a call from the school nurse, who only half the time would be convinced by our pleading that it was nothing—so that a few more hours might elapse before the apartment filled with their books and the paper wrappers from their snacks.

But now it was August, and we were at the beach. All winter we dreamed of the house, with its blue floors, the tiny periscope hole in the roof, the red chairs, the rickety porch with its view of the bay. The children turned brown. The sea was flat. At low tide, a little pool appeared, and a sandbar, and she, the youngest at three, stood on tiptoe in the water, screeching when an inch-high wave hit. “I think the water's actually cold,” she ran to tell us. “No, I think it's actually warm.” We sat by the edge in our low beach chairs, the same chairs that used to embarrass us when our parents brought them to the beach. Why do we have so much stuff? we would ask them, eager to be free of it all, the towels and swimsuits and bottles of juice and fruit, imagining ourselves alone on an empty stretch of beach, naked, with a rucksack. Now we're the ones who unload the car and carry the heaviest bags.

She's so little we let her run naked, even though we have learned that turning brown is bad. We are careless, self-indulgent, to let her do it. By late afternoon, the sun has slipped behind the enormous high dunes, and blue shadows lap at the water. When she comes up from the edge, she is shivering. Her older sisters and brother and their friends are far out in the waves, on their boogie boards and surfboards, unidentifiable in their black wetsuits. We keep track by counting. Is that Anna? We ask each other: Do you see Nick? There's Rose. “Come in now! Come in!” we scream at them, our arms making huge pinwheels so they will pay attention. It is easy for them to pretend they don't see us.

During the night, she coughs on and off, and wakes once. The wind on the bluff pounds the house. In the morning, it is hot and blue again. We get to the beach after lunch, but the sun is still high. From the top of the dune, shielding our eyes, we look for the cluster of bright umbrellas that mark the colony of our friends. They hail us. The older children jump like seals into the waves and swim out to their pals. She stays by the edge. Today, there is another child her age, but she's cranky and won't play. It's too much sun, she didn't sleep, we explain to the other child's parents. Secretly, we are annoyed: Why won't she just play nicely? The younger children are fooling around with the surfboard, and she wants to try. A wave rears up suddenly, a dragon, foaming at the mouth, and she's hurled underwater and onto the sand. Everyone races to help. How can we have allowed this to happen? This is appalling! She is young, much too young for these high jinks. She comes up sputtering. What kind of parents are we? Until someone else makes a mistake, our reputation is shaken.

That night, she wakes up every hour, coughing. The cough catches her throat, grips it, then lets go. We give her some children's medicine to make her sleep. At some point, I lie down beside her in her bed, and when I wake up it is morning.

The day is blustery and cool. On and off, we feel her forehead. Tonight is a friend's birthday, and we will be nine people for dinner. The middle children go next door to babysit for the younger ones. She sleeps upstairs through the noise. When everyone has left, she wakes up, coughing. When I put my arms around her she begins to vomit. Get a bucket, I say to the nearest child. They know the drill. We've been through this countless times, with one or another of them. We have been awakened by children standing by the side of the bed with bloody noses, by a decade of earaches. But now—and we don't know why—we are frightened. She vomits again and again into the bucket, taking rasping breaths. Her forehead is warm but not hot. Her arms flail, and she isn't focusing

We do not have a telephone. The cell phone works only if you walk a quarter mile down Corn Hill to the public-beach parking lot. There are no all-night drugstores. This is why we come here. We like it. We are against the plans for the new Stop & Shop in this small Cape Cod village.

Get Anne, I say. One of the children, white-faced, returns from next door with Anne, who left the table only twenty minutes ago. While we are nonchalant about our children, Anne's father was a doctor in rural South Africa, and knowing more—knowing what can happen—she is careful. When she peers into the bed, she agrees right away that something is wrong: the child looks odd. Her breathing is coming in shudders. Someone remembers that Giulia's grandmother, down the way, has a telephone. No doctor at the Health Services, in Provincetown, is on call for summer residents; we must call the Rescue Squad. We worry that we are being ridiculous, but we call. Her father goes out into the dark to wait for the Rescue Squad.

The van comes in five minutes, red lights flashing. Her temperature is 100.1 degrees, her vital signs are normal. If we are worried we can take her to the hospital in Hyannis, an hour away.

We decide to wait until morning. In the kitchen, she sits on my lap in one of the red chairs. Because we have run out of medicine and have not replaced it during the day—another sign of our foolhardiness, our nonchalance—even though it is too late, we call our friends up the road, Luke and Emily, the parents of our children's friends, and they arrive by car in what seems like an instant, bottle in hand. I take off my vomit-covered sweater. She throws up, just a little, on my shirt. But she is smiling, at Emily, who is looking at her with great tenderness, saying, Poor baby.

The next morning, while the other children sleep, we take her in the station wagon to the health clinic in Provincetown. The waiting room, streaming with light, is almost empty. Two emaciated men sit next to each other on the wall facing the parking lot. There are no appointments until later in the day, but the nurse, after looking at me, comes out to the parking lot to have a look at her. Immediately, there is an appointment. The nurses are beautiful and tall. This is Provincetown, and I wonder briefly if they are transvestites. The doctor's lovely mild face is perplexed. It looks like a virus. Her fever is 101.2 degrees. We are to alternate Tylenol and Motrin every three hours. Her skin is dry to the touch.

At home, she is hungry and wants lunch. She eats ramen noodles, and throws up. The older children wake up, eat breakfast, and are taken to the beach with the surfboards and boogie boards, their horrible pink juice, their box of Goldfish. Her fever disappears.

She wants to play Wiffle ball on the strip of sand on top of our dune. After playing for ten minutes, she goes inside and sleeps with her blanket on the couch. That morning, she vomits twice. In the morning, she got into our bed and, turning her head, vomited directly into my hair. She is hot again. On her back there are a few scattered red marks, as if a bird had walked along the short length of her spine. We call her doctor in New York. He is away, taking his child to college. We speak to another doctor, his partner. He says, “Take her back to Provincetown.”

Now at the clinic we are treated as old friends. “Hello, hello,” they say.

One of the tall and beautiful nurses takes her blood pressure. The doctor arrives. Her temperature is 102.4 degrees. When she coughs, she takes a moment to catch her breath. Her breathing is shallow, and she is whimpering. The doctor decides to take a blood count: Maybe there is an infection we can't see?

The blood test shows nothing. Her white-blood-cell count is normal. The doctor examines her again. The rash on her back has spread to her stomach: small red dots just under her skin, from sternum to groin. But now she has an infection in her left ear. This is good: there is something to do. New York is called, and agrees with the doctor's recommendation, a massive shot of an antibiotic called ceftriaxone.

It may also attack any bacterial infection that may be lurking. That day's notes say, “case assumed by Dr. Lazarus in New York,” followed by the phone number of the pediatrician's West End Avenue office. The antibiotic will be injected into the muscle of her thigh. Her father leaves the room. Hold her legs down, I'm told. I hold her small legs. Are her eyes red? It's hard to tell. She is crying. When we leave the clinic, we are both given get-well stickers. One for Mommy, the nurse says.

In the car back to Truro, past the long seep of dunes where the Pilgrims first found fresh water, I think: scarlet fever. Malaria. Diphtheria. Smallpox. Scurvy. Leeches. Flu? My aunt and my father had polio when they were children. My grandparents closed up their house in Brooklyn and moved to a hotel near the hospital. When we get home, she lies on the couch with her blanket. It's a rainy day, and the hill is full of children. Anna, Lev, and Joseph take turns reading to her. The Wolf eats Grandma; the Troll bellows from under the bridge. She smiles, on and off, and eats a few Goldfish crackers. Her four-year-old friend Adam goes in and out of the house cheerily, checking in. I count up in my head. Taking our children all together, we have thirty-eight years of child-rearing experience. If you include our friends who drop by and stand over the couch like figures in a nineteenth-century print,
The Invalid,
the number lurches up to a hundred and thirty-three. The consensus is that something's wrong with this child. And our friends are not keeping their own children away: the unspoken feeling is that, whatever this is, it isn't contagious. Later I will think, How did we know?

For supper, we have corn from the farm stand, cherrystones and grilled tuna for the grown-ups, and hamburgers for the children. She eats nothing. Asleep in our bed at the back of the house she wakes every half hour and throws up. She asks for water, but it comes right back up. In the morning, she begins vomiting long streaks of bright-green bile. When I change her soiled pajamas, which should be soaked because her skin is hot but are not, the rash has melted together into an angry range of welts across her trunk and back.

It is raining again. In the parking lot down the hill, I am on the cell phone to New York. For the first time, I lose my temper when talking to a doctor's office. Told, “The doctor will call you back,” I begin to scream into the phone, No, he will not call me back, you will get him, now. I know this is a bad idea. After a long time, the receptionist comes back to the phone. All the doctors are with patients. By now, I am crying. I tell her we have been patients in this practice for a decade, that I've never made such a phone call before, that I know exactly what is going on in the office—there are two kids with ear infections and five kids waiting for school checkups—and she is to get someone right now. Dr. Lazarus comes to the phone.

W
e return to Provincetown. It sounds to New York that she's lost so much fluid she may need to be hydrated. How will Provincetown know? They'll look at her, they'll know. When we get there, they call an ambulance.

Inside the ambulance, it's our old friends from the Rescue Squad. Should we have taken her to the hospital on Tuesday? They check her vital signs. This includes pressing her finger until the flesh under the nail turns white, and counting how long it takes for it to flush pink again. It takes too long. She's not getting enough oxygen. Or maybe just enough. Just enough isn't okay. I'm given a choice: either she can hold—or I can hold—a green bear that will breathe pure oxygen into her face or an oxygen mask will be put on over her face. I choose the green bear.

I'm kneeling next to the car seat, on the floor of the ambulance. The green bear starts to work. The technician has a last name—Silva—that's common in Provincetown. Is she a local girl? “You bet I am,” she says. “When I was in high school, I couldn't date—everyone was my cousin.” She has two kids. Last weekend, the two town ambulances made fourteen trips, a record. Looking down at my own child on the stretcher, I notice two things: the whites of her eyes are bright red, and the fingers on both hands look scorched, as if somewhere along the way she's burned herself.

In the emergency room, the technicians slide her onto a bed. Good-bye, good-bye. I am alone. Her father has followed the ambulance in the station wagon. When he explained in Provincetown he wanted to do this, it became immediately clear that he meant that literally: behind the ambulance, at ambulance speed. He was dissuaded. So he has driven, at a moderately reasonable pace, on the highway, but he's not here yet. A covey of nurses has gathered around her, and they insert an IV into her left hand. She is screaming. Then the ER doctor comes in. He is a man my own age called Nate Rudman—a familiar name. Do I know him? I knew a Seth Rudman in high school, I know a poet called Mark Rudman. Nate comes up blank. She is calming down on the bed. By now I am quite sure I know what is wrong: the little boy next door in New York had been exposed to Coxsackie virus, a minor, irritating, childhood malady. Before we left, it was going around the neighborhood. I am very busy being sure. I am relieved: the proof is her inflamed hands. I inform the doctor, Nate Rudman, that she has Coxsackie virus, but he pays no attention to me. He is gone from the room. The nurses flutter like pigeons. He returns. I tell him again about the boy next door with Coxsackie. No, he says. She does not have Coxsackie. His exact words are: She doesn't have Coxsackie disease. She has Kawasaki disease. It will take two weeks before I can say this properly. Excuse me? This disease, he says, is the primary cause of acquired, potentially fatal, coronary aneurysms in young children.

The blue room turns green. I am standing by the side of the bed. The bed has a bar. I hold on to it. A chair materializes. I sit down on it. Once, when I was a girl, I dove deep from a high bank covered with damp moss into a deep lake, and my mind went blank in the black cold water. I was wearing a Speedo bathing suit. I surface now into the brightly lit room. Before she was born, before we decided to have a child together—she is the first child of our marriage, and the only one—I thought, we are too happy, we are asking the evil eye to come among us.
Kenaharah,
my grandmother would say, if we were too much praised. Don't shine too much light or the Devil will see. The Devil is like a moth—he is attracted to light. When the children are admired, I instinctively deflect it. Pretty is as pretty does, I say. Stop reading twigs in the forest, you idiot Russian, my oldest friend laughs at me. But now it has come to pass.