Free Oxygen by Carol Cassella Page A

balancing of medication drips and electrical wires and breathing machines that can save a life or merely painfully prolong it. There was a chance still, said her cardiac surgeon. If the stress on her heart could be lightened enough to allow some healing, some trickle of oxygen-rich blood to its inner core, she might survive the surgery.
    They slipped a small pump through the flesh of her groin into her femoral artery and up into her aorta to lodge just beyond her flailing valve. The pump was timed to the electrical rhythms of my mother’s heart, inflating and deflating to siphon the blood forward, out to her body and her brain.
    I sat in the half-light and listened to the rhythmic thudding of the mechanical pump, muffled through the layers of her living flesh. I envisioned the submarine-shaped pump expanding and contracting in the bright blood of her aorta, its cord snaking down the pulsing vessel to erupt from her groin and connect her to the machinery. The sound lulled me into a realm where memories of my life with her and hope for my future could weave together, connect as a continuous line, without the scar of grief I knew her death would leave inside me.
    My father circled the floor like a confined animal, repeating the same questions over and over. I kept trying new words, new metaphors that might make the mystery of her failing body comprehensible to him. But as days went by and her kidneys stopped cleansing her bloodstream, her liver quit manufacturing enzymes and proteins, her bone marrow stopped creating new blood cells, waiting for surgery became moot. Now we were waiting for death.
    A meeting was gathered of her medical team, my sister, my father and myself. This time her cardiologist’s words were chosen haltingly, chosen to be soothing but without hope. He gently guided my father to the understanding that he must end this artificial extension of his wife’s life.
    I’m sure my mother never suspected she was raising a doctor. Female doctors were rare in her world. She taught me the things she believed I would need in my life: how to sew a bias-cut tie as a gift for my father one Christmas—a wide garishly flowered thing he wore once out of courtesy; how to separate the white from the yolk when making meringues, slithering the contents of the raw egg from half shell to half shell until the golden center swam naked in its clear membrane; how to pluck my eyebrows, put on a bra and pull sheer stockings up my legs without snagging the interlaced filaments.
    She taught me all the things my sister has put to excellent use in her life, all the complexities of stabilizing a home and joining two people and the generation they create together into a new and whole family—critical facts that make families work, passed from woman to woman, never tested or graded or ranked, but invaluable nonetheless. I stored them up to share with my own daughter someday, after the temporarily consuming labor of medical training was finished. Once I regained some control over my life, after my residency, I always knew, I would rejoin the intended stream of marriage and motherhood. I never meant to dam myself off from those. I just knew they would require careful scheduling.

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    After the first week people stop telling me how sorry they are or asking me if I’m holding up all right. Instead of being a disaster shared with everyone who works in the operating rooms at First Lutheran, it gradually becomes the silently screaming secret that sends an awkward hush over groups of surgical techs and nurses chatting at the coffee bar the minute I show up. I ask a question about the schedule, offer an opinion on the new epidural kits, give the most intentionally bland comment on the weather, and the responses return stained with pity.
    The other anesthesiologists at the hospital are bolder: “It happens to a lot of good doctors; I might have made all the same decisions”; “I know how you must feel. But for the grace of God I could have been