On the third Wednesday in June, after a lunch he’d hardly managed to eat, Donald Mathison reported to the fifth floor of the 400 Parnassus Avenue Medical Building. The weather had been unusually warm for the past several days, but inside the Oncology ward the air held an artificial chill, and gooseflesh rose on Donald’s arms as he crossed the threshold. He had a 3:30 p.m. appointment with the head of the department, and he needed to check in an hour early so the results from his blood draws would be available when the doctor came to see him. As he approached the front desk, Donald noticed the clock on the wall. It hadn’t yet reached two.
Donald gave his name to the woman at the desk, had his weight, heart rate and blood pressure recorded by the first nurse, had three vials of blood drawn from his right arm by a second nurse, and returned to the lobby waiting area. This was to be a routine check-up, much like the check-ups Donald had attended every three months for the past year. He’d be meeting with Dr. Kaufman, the oncology head, to discuss the results of the PET and CAT scans he’d undergone the previous day.
More than two years had passed since Donald’s release from the Blood and Bone Marrow Transplant Ward at Thornton Hospital, where he’d undergone an autologous stem cell transplant. The transplant had marked the end of, by Dr. Kaufman’s own description, an entirely successful treatment for stage IV non-Hodgkins lymphoma. Donald’s health, while initially slow to recover from the debilitating effects of the transplant, had eventually bloomed into a state of mild constancy, and in the past twelve months he hadn’t felt sick even once. For some time now hope had been flickering within him, a steadily growing flame.
The nurse called Donald’s name, and he rose from his chair and followed her to the examination room.
The room was rather small, with two chairs and a desk crowded against one wall, and the examination table against the other. Out of habit, Donald chose to sit on the table instead of the chairs. He sat there, the stirrups on either side of him, moving his dangling feet absently.
Several minutes passed, and then several more; more than a quarter of an hour. Donald sat thinking of his girlfriend, Kristine. When he’d left her that morning, she’d still been asleep. He’d pulled the blanket up to her chin, kissed her lips very lightly, and stood there watching her. This was a habit of his, watching her sleeping.
When twenty minutes had passed and the doctor still hadn’t arrived, a little quiver of dread sparked in Donald’s subconscious. Suddenly the room began to feel very small, the walls very close. He didn’t like to sit there with the stirrups on either side, caging him in. He didn’t like to feel the weight of his feet pulling on his knees. There were no windows and only one door in the room. Donald got up from the examination table, and opened the door.
As he did so he saw Dr. Kaufman striding up the hall toward him, carrying a manila folder in his left hand. Dr. Kaufman was a small man, with a curly froth of blond hair covering his head, and a sprightly way of carrying his body. He called out “Mr. Mathison” to Donald now, and brandished the manila folder. They shook hands in the doorway, and then went into the examination room. Dr. Kaufman took the seat at the desk, and Donald, eschewing the examination table this time, chose the chair beside it.
“How are you feeling, Donald?” Dr. Kaufman asked.
“Fine, doctor. I can’t complain.”
“We got the results to your PET and CAT scans back today,” he said, opening the folder before him, and laying it out on the desk. “For the most part, everything looks excellent.”
“I’m glad to hear it.”
“Your spleen is still enlarged, of course, but shows no sign of abnormal activity. All of your lymph nodes appear unexceptional.”
Donald sat there, nodding his head quietly.
“The only thing that lit up on the scans was a very small section on the left ventricle of your heart. You haven’t had any shortness of breath, or any pains in your chest, have you?”
Donald, suddenly aware of his chest, thought he felt a tightness there. A building pressure, as though some great invisible hand was gently squeezing. “No, I haven’t,” he said quietly.
“This might just be a false positive,” Kaufman said, looking up at Donald now. “The disease you had is not known for having any affect on the heart, nor are the treatments you underwent. Even so, you’re only two years out from your transplant, and I feel it’s best to be cautious.”
Donald nodded his head and swallowed.
“I’d like to schedule you for an echocardiogram, and an EKG. That way we’ll be able to get a look at your heart, and see if there are any abnormalities.”
The tightness was in Donald’s throat now, too, and he swallowed again, trying to clear it.
“I’ll write out a request for you,” Kaufman said, pulling a form out of the folder. He filled it in quickly, and continued “You can take this to the front desk, and have them schedule an appointment. Probably sometime next week would be good. The sooner the better, you know.”
Donald nodded his head again, and took the form.
The sun was low in the sky by the time Donald got home, but the air was still warm. Rather than catch the 44 bus, as he normally would have done, Donald had decided to walk back to his apartment through the park. When he opened his door he was greeted with the thick scent of sautéed garlic. Kristine had the table set, and soft music played on the stereo.
He walked into the kitchen and saw her there, cutting carrots for a salad. Her hair was long and loose, rich silk spilling down her back. Her beautiful mouth gently pursed, the lips soft and full, her dark eyes shining. The tightness returned to his throat as he looked at her, and a hollow ache filled his chest, as if his heart was dashing itself against his ribs with every beat. They had been living together for seven months.
He couldn’t speak.
She looked up from the carrot, and smiled at him. “How was work?” she asked.
He cleared his throat. He wanted to go up to her and catch her in his arms. Instead, he reached over and clutched the doorjamb. He cleared his throat again, and said “Fine.”
“You’re home late. Did you have to work overtime?”
“No. I walked home.”
“It was a nice day for a walk, wasn’t it?”
“It was. Beautiful.”
She put down the knife and carrot, and went to him. “Can I have a kiss,” she said, wrapping her arms around him.
“Of course,” he said, and gave her one.
Then, holding her there in the doorway, and looking over her head at the clock on the wall, he said “I had a doctor’s appointment today.”
“You did? What for?”
“Just a checkup. It’s been two years since I finished with my treatments.”
She squeezed him a little harder, and nuzzled her head against his neck. “I still can’t believe you’ve been through all of that. I can’t imagine you being that sick.”
He was quiet.
“What did the doctor say?” she asked.
“He said everything looks pretty good.” He paused, pressed his lips against her head, and pulled in the smell of her hair. “Something lit up on my heart, though.”
“What’s that mean?”
“Probably nothing. It might just be a glitch on one of the tests. But the doctor wants me to have my heart scanned next week.”
“Do you want me to go with you?”
He reached up with his hand and ran it through her hair, loosening the tangles. “No need. It’s probably nothing.”
“Are you sure?”
Donald stood there holding her. He could hear the stereo playing in the other room. He could hear the quiet rush of traffic out on the street. He saw the clock ticking on the wall, and he imagined his heart thumping in his chest, like a bloody fist clenching and unclenching. He held Kristine tightly, and imagined that he could feel her heart too, beating against him.
The nurse was a bald man, rocky faced and squat. He had clear, very pale blue eyes, like over-washed jeans. Around his eyes was a pattern of intricate little wrinkles, small enough that you wouldn’t see them unless you were very close to him. Donald was very close to him now, lying shirtless, on his left side.
The table that he was lying on had a thin padding stretched over it. His left arm was bent back so that his hand served as a pillow for his head, and his shoulder and his hip were obliged to carry much of his weight. He would spend more than an hour in this position, and by the time the nurse allowed him up, his hip would ache as if it were bruised, and pins and needles would scatter down his arm to his fingertips.
“I’m putting a little gel on the transducer, to help the ultrasound conduction for the echocardiogram,” the nurse said, just after Donald first lay down. It was the first time he’d spoken, other than to call Donald’s name in the waiting room, and to tell him to take his shirt off and lie down on the examination table. “It might be a little cold.”
The nurse pressed the wand-like transducer to the bottom of Donald’s sternum, where the wings of his ribcage met. The instrument was cold, and hard, and uncomfortable against the bones in his chest. The nurse pressed harder, and Donald grimaced, but said nothing.
A long cord ran out of the bottom of the transducer, and connected it to the computer at the head of the examination table. As the nurse moved the wand across Donald’s chest, a swath of gray appeared on the computer screen. The nurse pressed hard again, and the gray seemed to rush forward, as if the transducer was a camera moving through a bank of fog.
Suddenly a large, pulsing mass filled the screen. It was roughly the shape of a diamond, outlined in white with an uneven white cross in the middle that divided the mass into four chambers. Donald, who could see the screen from where he lay, knew that the diamond mass was his heart.
The nurse, with his left
hand holding the transducer steady, turned his body toward the screen, and reached for the computer’s mouse with his right. He moved the cursor and clicked a button. The screen flickered black, and the diamond mass was replaced by a section the shape of a pie-slice. One of the short arms of the cross could be seen in this pie-slice. It flapped rhythmically, violently, like a cello string plucked and stopped, then plucked and stopped again.
The nurse hit a few keys on the keyboard. The short flapping arm froze, and red and blue squares appeared on either side of it. He pressed a button on the mouse. The pie-slice, with its colored squares, disappeared, and the pulsing diamond filled the screen again. He chose another slice, and continued the process, only looking in Donald’s direction to check the position of the transducer.
Donald’s mind began to wander. He thought of Kristine.
Donald had met her in a bar. She was there with her roommate Rebecca, at a table near the jukebox. Rebecca was carrying on about something, waving her hands in the air and rolling her head side to side. Kristine was sitting across from her quietly, leaning her chin on her palm. The bar was mostly empty except for them. Donald walked up to the jukebox and started flipping through the selections, and before he’d finished, he felt a tap on his shoulder. It was Rebecca.
“What are you going to pick?” she asked, a sly smile on her lips.
“Um, I’m not sure yet,” Donald replied. “Any requests?”
“Play something lively for my roommate here. I can hardly ever get her to come out for a drink. Play some party music, so we can celebrate.”
“Do you like The Temptations?” he asked, turning to Kristine.
She smiled as if embarrassed, and nodded her head once. Something about the way she looked at him, something about the rich darkness of her eyes, made him pause. He smiled back.
He fed a dollar into the machine and picked a few songs. Then he took a seat at their table.
Thinking back on it now, as he lay on his side on the examination table, while the taciturn nurse clicked on different parts of his heart, Donald couldn’t remember any specific moment when the spark between him and Kristine had really caught flame. It may have been that very night, with Rebecca chirping on and on, and Kristine sitting quietly all the while. It may have been the next night, when he met with them at the bar again, or the night after, when he went to their house for a party they were having. He actually spoke with Rebecca more than Kristine during those first few days, because of Rebecca’s chatty nature. But all the while Kristine was there, in the background, pretty and quiet and calm. There was a sense of peacefulness to her, an absence of distress that he wanted very badly.
And she seemed to want him too. She had a way of finding him when he stepped out of the bar for a moment alone, and she was the one who walked him to the door when he left her party. He thought of that moment now, with his heart frozen on the screen, adorned with red and blue squares.
“Do you think I could see you sometime, just you and me?” he’d asked her then. He could hear the remaining guests behind her, back in the apartment, loud and raucous.
“Without Rebecca, you mean?”
“Yes. Without Rebecca.”
“I’d like that,” she said. “I was hoping you’d ask.”
And then, almost before he knew what he was doing, he’d leaned forward and kissed her lightly on the lips. It only lasted a moment before he broke away, surprised at what he’d done. She smiled.
“Call me, okay?” she said.
“I will. I’ll call you.”
He turned and stumbled down her steps, his own lips pulled tight in a grin, his heart thundering in his chest.
“I need to take some more shots from another angle,” the nurse told him. “I want you to prop yourself up on your elbow a little, so your left side stretches.”
Donald did as he was told.
“Now just hold that position.”
The nurse squeezed more of the gel onto the transducer, and pressed the point between two of the ribs on his left side. Donald grimaced again. His heart appeared on the screen, slightly flatter, with the cross replaced by a single line that divided the mass into two sections. The whole mass jolted and stopped, jolted and stopped.
How many times had his heart beaten, he wondered. How many times, since his birth, had that poor, heavily laden mass of muscle been called upon to crush itself for the sake of the rest of his body? And how many more times would it agree to shoulder that burden? Donald looked at his heart, up on the screen. How much longer before it gave in?
The nurse took several more shots, working in silence, not even casting a glance at Donald. In fourteen minutes, he was done. “Now the EKG,” he said. “Lie down on your back, and stay still.”
Donald rolled onto his back. The nurse wiped the remaining gel off his chest and side, and started attaching the sticky, circular leads. One on each arm, one on his left leg, and nine across his chest. The nurse wheeled the EKG machine up, and began the process of connecting it, wire by wire, to each of the leads. The ceiling above Donald was comprised of individual tiles. Each tile was perforated with a grid of small holes. Donald started counting the holes.
The ceiling in Kristine’s old room, when she’d been living with Rebecca, was cracked in places, as if the paint had been put on too thick, too heavy, so that it sagged and split when it dried. He’d noticed it on the night when he first slept with Kristine, three weeks after he met her and Rebecca in the bar. They’d made love, awkward in the newness of the experience, and then lay there together quietly as she drifted off to sleep. In her slumber Kristine huddled against him, her head on his shoulder, her hand on his chest. Donald wrapped his arm around her back, his hand gently moving, caressing. It was the first time he’d been with a woman since his diagnosis.
Kristine’s room was at the front of the apartment, with windows that opened over a bar on the street below. The bar was still serving drinks that evening, and a few late-night revelers were out in the front, smoking cigarettes. Donald could hear them talking, loud and hard to cut through the music of the bar and the haze of the alcohol. It was a Friday night, and there was a DJ spinning hip-hop records, the steady bass drum thumping like a heartbeat.
As he lay there, looking at the ceiling and listening to the street, he tried to stay as still as possible. Except for his fingertips sliding up and down on Kristine’s back, Donald didn’t move at all.
He hadn’t told her much about the treatments he’d undergone, or the illness that prompted them. Whenever such talk breached the placid surface of their deepening relationship, he emphasized the positive outlook, or skirted over the topic entirely. And he didn’t do it to purposely mislead her; he himself needed to approach it in this way. It was time to move on.
The cracks in the ceiling, hardly visible in the light that came through the window, crawled around the edges of the light fixture mounted above the center of the room, and reached out to the corners like spider webs. Donald couldn’t sleep for watching them. Their color was slightly darker than the paint they broke through. Darker, or dirtier, he couldn’t tell which.
The noise in the street, cutting in through the closed window, seemed violent and mindless, like despair itself.
Donald called the Oncology department the next day to get the results of the echocardiogram and the EKG. The phone rang six times before a nurse picked it up. “This is Donald Mathison,” he said. “I’m calling to speak with Dr. Kaufman.”
“Is he expecting your call?”
“I’ll have to put you on hold for a minute.”
There was a click, and then the muffled sound of classical music coming through the earpiece, thin and anemic, as if it were very far off. It was string concerto, and the violin was most audible, a high, plaintive trilling, soaring upwards like a bird. The rest of the orchestra was mottled and blurred, a dark swelling beneath the violin. The high melody arched and fluttered, disappeared in the muddy harmony, and reemerged desperately, striving upwards again. A beautiful, frantic ascension. A soaring grace. And then, abruptly, there was another click, and a hissing silence replaced the concerto.
“Mr. Mathison?” Kaufman’s voice said.
“Yes, that’s me.”
“This is Dr. Kaufman. I’ve got the results of the tests you took yesterday.”
There was another pause. Was Kaufman reaching for a folder, or pulling a paper from an envelope? Was it something else? Donald stood there, gripping the phone, unaware of anything save that hissing silence, yearning into it for an answer. His throat constricting, a pressure building in his head, his heart fast in his chest.
Kaufman cleared his throat, and spoke.